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JERRY WALTER FREDERICK RPH
NPI 1033759899
Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Bloomington, IN

Active since January 09, 2020
4025 S OLD STATE ROAD 37, BLOOMINGTON, IN 47401(812) 824-5205(812) 824-5207 Get Directions Write a Review

NPPES record last updated: January 9, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerry Walter Frederick Rph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY WALTER FREDERICK RPH (NPI 1033759899) is an individual pharmacist clinician (phc)/ clinical pharmacy specialist in Bloomington, Indiana, licensed in Indiana (26012786A) and active in the NPI registry since January 2020.

NPPES Registry Identity

NPI1033759899
Entity TypeIndividualMale
Primary Taxonomy1835P0018X
Provider Legal NameJERRY WALTER FREDERICKCredential: RPH
Location Address4025 S OLD STATE ROAD 37Bloomington, IN 47401-7482
Mailing Address4025 S Old State Road 37Bloomington, IN 47401-7482 · (812) 824-5205
Phone(812) 824-5205
Fax(812) 824-5207
Sole ProprietorNo
Enumeration DateJanuary 9, 2020
✔ NPI 1033759899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacist · Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPharmacy Service Providers
Taxonomy Code1835P0018X
License✔ Licensed in IN · 26012786A
Definition
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.
4025 S OLD STATE ROAD 37, Bloomington, IN 47401
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KROGER LIMITED PARTNERSHIP I
Pharmacy (Community/Retail Pharmacy)
4025 S OLD STATE ROAD 37
BLOOMINGTON, IN 47401
Monroe County (812) 824-5205
MRS. CAROL DIANNE PARRISH R.PH.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
4025 S OLD STATE ROAD 37
BLOOMINGTON, IN 47401
Monroe County (812) 803-7250
MURPHY O'TOOLE
Pharmacist
4025 S OLD STATE ROAD 37
BLOOMINGTON, IN 47401
Monroe County (812) 824-5205
AVIS KATHLEEN PERKINS PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
4025 S OLD STATE ROAD 37
BLOOMINGTON, IN 47401
Monroe County (812) 824-5205
ANTHONY JACOB ST JOHN
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
4025 S OLD STATE ROAD 37
BLOOMINGTON, IN 47401
Monroe County (812) 336-6223

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Frederick's NPI number?

The NPI number for Jerry Frederick is 1033759899. It was assigned to this individual provider in the NPPES registry on January 9, 2020.

Where is Jerry Frederick located?

Jerry Frederick practices at 4025 S Old State Road 37, Bloomington, IN 47401. The listed phone number is (812) 824-5205.

What is Jerry Frederick's specialty?

The primary specialty registered for this NPI is Pharmacist, specializing in Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, with taxonomy code 1835P0018X.

When was this NPI record last updated?

The NPPES record for Jerry Frederick was last updated on January 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.