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CRYSTAL LYNN FREDERICK RD
NPI 1255112678
Dietitian, Registered in Oklahoma City, OK

Active since October 11, 2023
5208 W RENO AVE, OKLAHOMA CITY, OK 73127(405) 948-4900(405) 948-4933 Get Directions Write a Review

NPPES record last updated: October 11, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Crystal Lynn Frederick Rd NPPES

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

CRYSTAL LYNN FREDERICK RD (NPI 1255112678) is an individual dietitian, registered in Oklahoma City, Oklahoma and active in the NPI registry since October 2023.

NPPES Registry Identity

NPI1255112678
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameCRYSTAL LYNN FREDERICKCredential: RD
Location Address5208 W RENO AVEOklahoma City, OK 73127-6344
Mailing Address4913 W Reno AveOklahoma City, OK 73127-6339 · (405) 948-4900 · Fax (405) 948-4933
Phone(405) 948-4900
Fax(405) 948-4933
Sole ProprietorNo
Enumeration DateOctober 11, 2023
NPPES CertifiedOctober 11, 2023
✔ NPI 1255112678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
5208 W RENO AVE, Oklahoma City, OK 73127
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crystal Lynn Frederick Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Crystal Frederick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Central Oklahoma American Indian Health Council, Inc.
0.2 mi
Federally Qualified Health Center (FQHC)
4913 W RENO AVE
Oklahoma City, OK 73127
  • Reassigned Medicare billing, Texas enrollment
  • 86 clinicians in this Medicare group
NPI 1407969728 (405) 948-4900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

MEGHIN OTILLIA DYSINGER
Health and Wellness Coach
5208 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
VERONICA VALLES MA
Counselor (Mental Health)
5208 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
AISA TRICE RD
Dietitian, Registered
5208 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
STETSON ROBERT SCHMITT DPT, OCS
Physical Therapist
5208 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
DR. BROOKE SARAH MUELLER MD
Pediatrics
5208 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
BRYAN ANDREW FEHR
Community Health Worker
5208 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
CHERYL LYNN COBB
Dental Hygienist
5208 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
DR. GABRIELLA ELISABETH PIERCE MD
Pediatrics
5208 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900

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 Crystal Frederick's NPI number?

The NPI number for Crystal Frederick is 1255112678. It was assigned to this individual provider in the NPPES registry on October 11, 2023.

Where is Crystal Frederick located?

Crystal Frederick practices at 5208 W Reno Ave, Oklahoma City, OK 73127. The listed phone number is (405) 948-4900.

What is Crystal Frederick's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Crystal Frederick enrolled in Medicare?

Yes. Crystal Frederick is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Crystal Frederick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Crystal Frederick reassigns Medicare benefits to Central Oklahoma American Indian Health Council, Inc. (Oklahoma City, OK). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Crystal Frederick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Crystal Frederick was last updated on October 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.