Individual provider Active NPI

Lynn G Fredes

  • Family Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1912312372
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP5680 Issued in AZ
Practice address
3255 S Rural Rd
Tempe, AZ 85282-3853
Phone
(480) 304-5467
Fax
(480) 304-5468
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN159544 AZ
Family Nurse Practitioner 363LF0000X AP5680 AZ Primary

Addresses

Primary practice location

3255 S Rural Rd
Tempe, AZ 85282-3853

Mailing address

PO Box 932958
Cleveland, OH 44193-0028
Phone (615) 425-4211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20140825002773 AZ Practitioner - Nurse Practitioner 6305064817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Little Clinic of Arizona LLCGroup PAC ID 4981797982, 43 clinicians

Practice addresses (Care Compare)

1300 S Watson Rd
Buckeye, AZ 85326-6303
Phone (623) 241-5322

Merit-based Incentive Payment System (MIPS)

Final score
84.28 of 100Reported as group
Quality
69.93
Promoting interoperability
100
Improvement activities
40
Cost
77.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Arizona LLC Family CurrentSince Feb 10, 2015 Accepting new patients

Locations

1300 S Watson Rd
Buckeye, AZ 85326
Phone (623) 241-5322

6470 S Higley Rd
Gilbert, AZ 85298
Phone (480) 809-2409

1935 N Stapley Dr
Mesa, AZ 85203
Phone (480) 339-6178

2727 W Bell Rd
Phoenix, AZ 85053
Phone (602) 680-2386

3255 S Rural Rd
Tempe, AZ 85282
Phone (480) 304-5467

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

Interoperability endpoints

  • Direct secure messaging: lynn.fredes@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1912312372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028",
            "telephone_number": "615-425-4211",
            "fax_number": "615-425-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 S RURAL RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852823853",
            "telephone_number": "480-304-5467",
            "fax_number": "480-304-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDES",
        "first_name": "LYNN",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN159544",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.