Individual provider Active NPI

Shaena Freeman, MD

  • Family Medicine Physician
  • Holland, MI
National Provider Identifier
1023490943
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301108397 Issued in MI
Practice address
1061 Washington Ave
Holland, MI 49423-5216
Phone
(616) 393-8100
Fax
(877) 451-0226
NPI assigned
Jun 27, 2015
Last updated
May 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301108397 MI Primary

Addresses

Primary practice location

1061 Washington Ave
Holland, MI 49423-5216

Mailing address

1061 Washington Ave
Holland, MI 49423-5216
Phone (616) 393-8100

Other identifiers 1

IdentifierTypeStateIssuer
900149064OtherMIPRIORITY HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180719001220 MI Practitioner - Family Practice 5193030476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1061 Washington Ave
Holland, MI 49423-5216

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shaena Freeman, MD PLLC Family Medicine CurrentSince Nov 25, 2021 Accepting new patients
Dayone City Care Family Medicine PastSince Aug 6, 2018 Accepting new patients

Locations

1061 Washington Ave
Holland, MI 49423
Phone (616) 393-8100

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-dayone
  • FHIR API: https://fhir4.healow.com/fhir/r4/HGFGCD/Endpoint/HGFGCD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1023490943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494235216",
            "telephone_number": "616-393-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494235216",
            "telephone_number": "616-393-8100",
            "fax_number": "877-451-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "SHAENA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-27",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301108397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "900149064",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.