JOAN LOUISE FRIEDMAN (AGNP) – Gerontology Nurse Practitioner, NPI 1104603828

JOAN LOUISE FRIEDMAN (AGNP) is a healthcare provider. based in Saint louis, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials AGNP. They hold a License No. 2023012582 (MO). The NPI Number for JOAN LOUISE FRIEDMAN (AGNP) is 1104603828

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
JOAN LOUISE FRIEDMAN (AGNP)
NPI
1104603828
Phone
(844) 735-4710
Address
10010 Kennerly Rd
Enumeration Date
14 September 2023
Last Update Date
16 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3143884121
Graduation Year
2023 (3 years ago)
PAC ID
5597109066
Group Practice PAC ID
1052605383
Professional Enrollment ID
I20240223000668
Address ID
MO631471606SA1265XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:2State licenses:1Digital endpointsOther names

7,017 NURSE PRACTITIONER in MO

Provider Addresses for JOAN LOUISE FRIEDMAN (AGNP)

  • 10010 Kennerly Rd

    Saint Louis, MO 631282106

    Phone: (844) 735-4710

    Type: Location

  • 615 S NEW BALLAS RD

    SAINT LOUIS, MO 631418221

    Phone: (844) 735-4710

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240223000668INurse PractitionerMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63128)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052605383View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerKS
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerTN
Nurse PractitionerMO

Reviews

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Frequently asked questions

Where can patients find JOAN LOUISE FRIEDMAN (AGNP)'s NPI?
You can confirm JOAN LOUISE FRIEDMAN (AGNP) with NPI 1104603828; it appears in the national provider directory.
Does this profile mean JOAN LOUISE FRIEDMAN (AGNP) is currently active?
Yes — JOAN LOUISE FRIEDMAN (AGNP) appears active in the national provider directory.
What kind of provider is JOAN LOUISE FRIEDMAN (AGNP)?
The page reflects Gerontology Nurse Practitioner for JOAN LOUISE FRIEDMAN (AGNP). Clinical services aligned with this taxonomy classification.
Does JOAN LOUISE FRIEDMAN (AGNP) practice in Missouri?
You will see Saint Louis, Missouri on file for JOAN LOUISE FRIEDMAN (AGNP) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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