Individual provider Active NPI

Thomas Dean Freed, OD

  • Optometrist
  • Grafton, WI
National Provider Identifier
1043226947
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1467 Issued in WI
Practice address
1106 Washington St
Grafton, WI 53024-1916
Phone
(262) 375-0220
Fax
(262) 375-0780
NPI assigned
Jul 31, 2006
Last updated
Mar 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1467 WI Primary

Addresses

Primary practice location

1106 Washington St
Grafton, WI 53024-1916

Mailing address

1106 Washington St
Grafton, WI 53024-1916
Phone (262) 375-0220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1043226947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WASHINGTON ST",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530241916",
            "telephone_number": "262-375-0220",
            "fax_number": "262-375-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 WASHINGTON ST",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530241916",
            "telephone_number": "262-375-0220",
            "fax_number": "262-375-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREED",
        "first_name": "THOMAS",
        "middle_name": "DEAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.