Individual provider Active NPI

Jill A Frerichs, DPM

  • Podiatrist
  • Clive, IA
National Provider Identifier
1962547356
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
792 Issued in IA
Practice address
12499 University Ave
Suite 210
Clive, IA 50325-8288
Phone
(515) 440-2676
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 792 IA Primary

Addresses

Primary practice location

12499 University Ave
Suite 210
Clive, IA 50325-8288

Mailing address

12499 University Ave
Suite 210
Clive, IA 50325-8288
Phone (515) 440-2676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070313000166 IA Practitioner - Podiatry 7012976350 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pella Regional Health CenterGroup PAC ID 9931005873, shared by 10 NPIs, 96 clinicians

Practice addresses (Care Compare)

404 E 2ND St
Prairie City Medical Clinic
Prairie City, IA 50228-8829
Phone (515) 994-2617

404 Jefferson St
Pella, IA 50219-1257

405 Monroe St
Pella, IA 50219-1189
Phone (641) 628-3832

Hospital & facility affiliations

  • Pella Regional Health Center Hospital, Pella, IA, CCN 161367

Merit-based Incentive Payment System (MIPS)

Final score
91.84 of 100Reported as group
Quality
91.13
Promoting interoperability
100
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
792IAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Knoxville Community Hospital Inc CurrentSince Jul 1, 2017 Accepting new patients
Pella Regional Health Center Current Accepting new patients
Pella Regional Health Center CurrentSince Mar 1, 2023 Accepting new patients
Knoxville Community Hospital Inc Current Accepting new patients
Pella Regional Health Center CurrentSince Mar 1, 2023 Accepting new patients
Des Moines University Osteopathic Medical Center Past Accepting new patients

Locations

1202 W Howard St
Knoxville, IA 50138
Phone (641) 828-7144

1002 S Lincoln St
Knoxville, IA 50138
Phone (641) 842-1464

405 Monroe St
Pella, IA 50219
Phone (641) 621-2200

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1962547356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12499 UNIVERSITY AVE",
            "address_2": "SUITE 210",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258288",
            "telephone_number": "515-440-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12499 UNIVERSITY AVE",
            "address_2": "SUITE 210",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258288",
            "telephone_number": "515-440-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRERICHS",
        "first_name": "JILL",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.