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JENNIFER B FREDRICKSON APN
NPI 1689710402
Nurse Practitioner - Women's Health in Southaven, MS

Active since January 29, 2007PECOS EnrolledAccepts Medicare Assignment
3964 GOODMAN RD E STE 131, SOUTHAVEN, MS 38672(662) 856-8440 Get Directions Write a Review

NPPES record last updated: December 1, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 1, 2021, Jan 30, 2019, Jan 21, 2019 and 2 more (5 updates tracked since 2018).

About Jennifer B Fredrickson Apn NPPES

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

JENNIFER B FREDRICKSON APN (NPI 1689710402) is an individual women's health provider in Southaven, Mississippi, licensed in Mississippi (R854891) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, is affiliated with Baptist Memorial Hospital Desoto, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1689710402
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameJENNIFER B FREDRICKSONCredential: APN
Location Address3964 GOODMAN RD E STE 131Southaven, MS 38672-8762
Mailing Address3964 Goodman Rd E Ste 131Southaven, MS 38672-8762 · (662) 856-8440
Phone(662) 856-8440
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJanuary 29, 2007
Last NPPES UpdateDecember 1, 20215 updates tracked since enumeration
NPPES CertifiedDecember 1, 2021
✔ NPI 1689710402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
License✔ Licensed in MS · R854891
3964 GOODMAN RD E STE 131, Southaven, MS 38672
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jennifer B Fredrickson Apn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800838525
PECOS Enrollment IDI20051003000410
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

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

Ivyraine Women's Clinic
Same address
Women's Health
3964 GOODMAN RD E STE 131
Southaven, MS 38672
  • Reassigned Medicare billing, Mississippi enrollment
  • Medicare enrollment name: Ivyraine Womens Clinic
  • 3 clinicians in this Medicare group
NPI 1962166264 (662) 856-8440

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

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
85 services64 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
53 services53 patients
Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
44 services44 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
39 services39 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
33 services25 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
32 services30 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Memorial Hospital Desoto

Acute Care Hospitals · Southaven, MS
1/5 CMS rating
OwnershipProprietary
CMS Certification Number250141
Location7601 Southcrest ParkwaySouthaven, MS 38671 · De Soto County
Emergency services Birthing friendly

Methodist Healthcare - Olive Branch Hospital

Acute Care Hospitals · Olive Branch, MS
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number250167
Location4250 Bethel RoadOlive Branch, MS 38654 · De Soto County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38672 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

REGINA CHRISTY SMITH APN
Nurse Practitioner (Women's Health)
3964 GOODMAN RD E STE 131
SOUTHAVEN, MS 38672
Desoto County (662) 856-8440
IVYRAINE WOMEN'S CLINIC
Nurse Practitioner (Women's Health)
3964 GOODMAN RD E STE 131
SOUTHAVEN, MS 38672
Desoto County (662) 856-8440

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 Jennifer Fredrickson's NPI number?

The NPI number for Jennifer Fredrickson is 1689710402. It was assigned to this individual provider in the NPPES registry on January 29, 2007.

Where is Jennifer Fredrickson located?

Jennifer Fredrickson practices at 3964 Goodman Rd E Ste 131, Southaven, MS 38672. The listed phone number is (662) 856-8440.

What is Jennifer Fredrickson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Is Jennifer Fredrickson enrolled in Medicare?

Yes. Jennifer Fredrickson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jennifer Fredrickson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Fredrickson reassigns Medicare benefits to Ivyraine Women's Clinic (Southaven, MS). 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 Jennifer Fredrickson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Fredrickson accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Jennifer Fredrickson 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.

Is Jennifer Fredrickson affiliated with any hospitals?

According to CMS data, Jennifer Fredrickson is affiliated with Baptist Memorial Hospital Desoto and Methodist Healthcare - Olive Branch Hospital.

When was this NPI record last updated?

The NPPES record for Jennifer Fredrickson was last updated on December 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.