Pauline Frederick, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9446475 Issued in FL

Practice address

12600 Creekside LN Ste 6
Fort Myers, FL 33919-3353

Phone

(239) 343-9219

Fax

(239) 343-9218

NPI assigned

Jun 9, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Pauline Williams Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.39 of 100Reported as group

Quality

74.12

Promoting interoperability

100

Improvement activities

40

Cost

77.17

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southwest Florida Mobile Wound Care LLC

  • Family Nurse Practitioner
  • Estero, FL
  • NPI 1487336863
  Medicare reassignment NPD
• Lee Health System Inc

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD (past)
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1881853463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9219",
            "fax_number": "239-343-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 CREEKSIDE LN STE 6",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193353",
            "telephone_number": "239-343-9219",
            "fax_number": "239-343-9218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1703 Country Club Rd Ste 103&104",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466008",
            "country_code": "US",
            "telephone_number": "910-333-0283",
            "fax_number": "910-333-0513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1703 Country Club Rd Ste 103&104",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466008",
            "country_code": "US",
            "telephone_number": "910-333-0283",
            "fax_number": "910-333-0513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "PAULINE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004371",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9446475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULINE",
            "last_name": "WILLIAMS",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Celeste V Frazier, CNM
• Fred a Liebowitz MD PA
• Fred a Liebowitz MD PA
• Fred J Burford, II DO, PA
• Rhonda E Frederick Elmer, LMT
• Sarah Frederick, OTR/L
• Freedom Dental of Fort Myers PA
• Freedom Mental Health Services
• Linda F Freeman, M.A., L.M.H.C.
• Olga Freeman, MD

• Family Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.