MARJORY FREDERIC PMHNP-BC
NPI 1871294447
Nurse Practitioner - Psychiatric/Mental Health in Las Vegas, NV

Q: What is Marjory Frederic's NPI number?

The NPI number for Marjory Frederic is 1871294447. It was assigned to this individual provider in the NPPES registry on March 13, 2023.

Q: What is Marjory Frederic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Marjory Frederic was last updated on May 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.

Active since March 13, 2023PECOS Enrolled

5940 S RAINBOW BLVD STE 400, LAS VEGAS, NV 89118(702) 854-6853(702) 758-7315 Get Directions Write a Review

NPPES record last updated: May 24, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 24, 2025, Jan 7, 2025, Oct 19, 2023 and 1 more (4 updates tracked since 2023).

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About Marjory Frederic Pmhnp-bc NPPES

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

MARJORY FREDERIC PMHNP-BC (NPI 1871294447) is an individual psychiatric/mental health provider in Las Vegas, Nevada, licensed in Nevada (871409) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Los Angeles.

NPPES Registry Identity

NPI1871294447

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMARJORY FREDERICCredential: PMHNP-BC

Location Address5940 S RAINBOW BLVD STE 400Las Vegas, NV 89118-2507

Mailing Address5940 S Rainbow Blvd Ste 400Las Vegas, NV 89118-2507 · (702) 854-6853 · Fax (702) 758-7315

Phone(702) 854-6853

Fax(702) 758-7315

Sole ProprietorYes

Enumeration DateMarch 13, 2023

Last NPPES UpdateMay 24, 20254 updates tracked since enumeration

NPPES CertifiedMay 24, 2025

✔ NPI 1871294447 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in NV · 871409✔ Licensed in CA · 95032219

Also ListedRegistered Nurse · Case ManagementTaxonomy 163WC0400X · License RN78446 (NV)

5940 S RAINBOW BLVD STE 400, Las Vegas, NV 89118

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Secondary Practice Location 1

Location 13415 S Sepulveda Blvd Fl 11Los Angeles, CA 90034-6060 · Phone (702) 854-6853 · Fax (702) 758-7315

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marjory Frederic Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Marjory Frederic reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PC

379 mi

Mental Health

99 S ALMADEN BLVD STE 600
San Jose, CA 95113

Reassigned Medicare billing, California enrollment
3,139 clinicians in this Medicare group

NPI 1154994846 (408) 402-4385

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89118 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

$88.51 typical visit price

range $57.07 – $173.24

Typical copayment $22.12 (range $14.26 – $43.31)

Most-billed visit code 99203

Established Patient

$100.60 typical visit price

range $18.27 – $140.96

Typical copayment $25.15 (range $4.56 – $35.24)

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 7

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

LIVING WATER PSYCHIATRY PLLC

Nurse Practitioner (Psychiatric/Mental Health)

5940 S RAINBOW BLVD STE 400
LAS VEGAS, NV 89118

Clark County (702) 854-6853

SONGBIRD HEALTH NV LLC

Behavior Analyst

5940 S RAINBOW BLVD STE 400
LAS VEGAS, NV 89118

Clark County (702) 891-4875

KATHERINE LYNN CARTER RDN, LD

Dietitian, Registered

5940 S RAINBOW BLVD STE 400
LAS VEGAS, NV 89118

Clark County (734) 255-1290

CARLA JENKINS DOULA

Doula

5940 S RAINBOW BLVD STE 400
LAS VEGAS, NV 89118

Clark County (773) 317-5177

LINDA AMPOFO LMFT

Marriage & Family Therapist

5940 S RAINBOW BLVD STE 400
LAS VEGAS, NV 89118

Clark County (702) 372-2450

MARIAH JEREMIAH MSW, LCSW

Social Worker (Clinical)

5940 S RAINBOW BLVD STE 400, PMB 81116
LAS VEGAS, NV 89118

Clark County (775) 375-5734

KYNAYDIA N NELSON

Counselor (Professional)

5940 S RAINBOW BLVD STE 400
LAS VEGAS, NV 89118

Clark County (702) 527-8032

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 Marjory Frederic's NPI number?

The NPI number for Marjory Frederic is 1871294447. It was assigned to this individual provider in the NPPES registry on March 13, 2023.

Where is Marjory Frederic located?

Marjory Frederic practices at 5940 S Rainbow Blvd Ste 400, Las Vegas, NV 89118. The listed phone number is (702) 854-6853.

What is Marjory Frederic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Marjory Frederic enrolled in Medicare?

Yes. Marjory Frederic is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Marjory Frederic's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marjory Frederic reassigns Medicare benefits to Grow Healthcare Group PC (San Jose, CA). 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 Marjory Frederic'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 Marjory Frederic was last updated on May 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.