1. Home
  2. Directory
  3. Wyoming
  4. Jackson
  5. Specialist
  6. NPI Profile

DR. O'ANN KARIN FREDSTROM MD
NPI 1225108657
Specialist in Jackson, WY

Active since November 09, 2006Opted out of Medicare · through Jul 1, 2027
610 WEST BROADWAY, SUITE L02, JACKSON, WY 83001(307) 734-8800(307) 734-8900 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. O'ann Karin Fredstrom Md NPPES

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

DR. O'ANN KARIN FREDSTROM MD (NPI 1225108657) is an individual specialist in Jackson, Wyoming, licensed in Wyoming (5032A) and active in the NPI registry since November 2006. She has opted out of Medicare through July 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1225108657
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameDR. O'ANN KARIN FREDSTROMCredential: MD
Location Address610 WEST BROADWAY, SUITE L02Jackson, WY 83001
Mailing AddressP O Box 15540Jackson, WY 83002 · (307) 734-8800 · Fax (307) 734-8900
Phone(307) 734-8800
Fax(307) 734-8900
Sole ProprietorYes
Enumeration DateNovember 9, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1225108657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in WY · 5032A
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
610 WEST BROADWAY, Jackson, WY 83001
Open in Google Maps ↗

Other Identifiers 3

Medicare ID-Type UnspecifiedW303497
Medicare UPINE91440WY
Medicaid113880400WY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. O'ann Karin Fredstrom Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2017 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2017
Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

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

PAULA JO RIDGWAY D.D.S.
Dentist (General Practice)
610 WEST BROADWAY
JACKSON, WY 83001
Teton County (307) 732-2273

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 O'ann Fredstrom's NPI number?

The NPI number for O'ann Fredstrom is 1225108657. It was assigned to this individual provider in the NPPES registry on November 9, 2006.

Where is O'ann Fredstrom located?

O'ann Fredstrom practices at 610 West Broadway Suite L02, Jackson, WY 83001. The listed phone number is (307) 734-8800.

What is O'ann Fredstrom's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is O'ann Fredstrom enrolled in Medicare?

No. O'ann Fredstrom has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does O'ann Fredstrom accept?

Health plans from Blue Cross Blue Shield of Wyoming list O'ann Fredstrom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for O'ann Fredstrom was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.