Individual provider Active NPI

Sharon Kay Frederick, RN

  • Registered Nurse
  • University Place, WA
National Provider Identifier
1962846436
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00167084 Issued in WA
Practice address
3913 Brouse Blvd W
University Place, WA 98466-1513
Phone
(253) 564-0289
Fax
(253) 564-0289
NPI assigned
Apr 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00167084 WA Primary

Addresses

Primary practice location

3913 Brouse Blvd W
University Place, WA 98466-1513

Mailing address

3913 Brouse Blvd W
University Place, WA 98466-1513
Phone (253) 564-0289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00167084WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1962846436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3913 BROUSE BLVD W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984661513",
            "telephone_number": "253-564-0289",
            "fax_number": "253-564-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3913 BROUSE BLVD W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984661513",
            "telephone_number": "253-564-0289",
            "fax_number": "253-564-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "SHARON",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-26",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00167084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.