Elaine M Fredrickson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3014562 Issued in KY

Practice address

4700 N Congress Ave
Ste 103
West Palm Beach, FL 33407-3284

Phone

(561) 255-3131

Fax

(855) 346-3451

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Estill Medical Clinic, PSCGroup PAC ID 5597845255, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marcum and Wallace Memorial Hospital Hospital, Irvine, KY, CCN 181301

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: efredrickson@estillmedicalclinic.qrsdm.com

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

• Estill Medical Clinic, PSC

  • Family Medicine Physician
  • Irvine, KY
  • NPI 1154500296
  Medicare reassignment Care Compare group NPD
• The Medical Group of South Florida Inc

  • Specialist
  • West Palm Beach, FL
  • NPI 1700176013
  NPD (past)
• The Medical Group of South Florida, Inc

  • Specialist
  • West Palm Beach, FL
  • NPI 1023454063
  NPD (past)
• Western Communities Family Practice Assoc Inc

  • Family Medicine Physician
  • Wellington, FL
  • NPI 1043271596
  NPD (past)

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

• Mercy Health-Marcum & Wallace Hospital LLC

  dba Mercy Health Marcum and Wallace Hospital

  • Critical Access Hospital
  • Irvine, KY
  • NPI 1487643821
  Care Compare affiliation

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1972564433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5336 ANN ARBOR DR",
            "city": "BOKEELIA",
            "state": "FL",
            "postal_code": "339223016",
            "telephone_number": "561-248-9297",
            "fax_number": "561-248-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N CONGRESS AVE",
            "address_2": "STE 103",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073284",
            "telephone_number": "561-255-3131",
            "fax_number": "855-346-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Court St",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "KY",
            "postal_code": "403361089",
            "country_code": "US",
            "telephone_number": "606-723-2167",
            "fax_number": "606-723-2112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "ELAINE",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ARNP9186537",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100814330",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrice Ann Fraser, CERTIFICATION
• Thomas Francis Fraser, D.D.S.
• Andrew Frazier, MS, LMHC
• Michael Frederick, MD
• Sharron Frederick, LCSW
• Freedman & Haas PA
• Douglas Freedman, D.D.S.
• Gail Marie Freel, MA,OTR/L,BCP
• Trinea Freeman Martin, MHP
• Danyelle Leatrice Freeman, RPH

• Family Nurse Practitioner in West Palm Beach, FL
• Providers in West Palm Beach, 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 May 23, 2022; 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.