Individual provider Active NPI

Carol Freshley, FNP

  • Family Nurse Practitioner
  • Portland, ME
National Provider Identifier
1043652779
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP131047 Issued in ME
Practice address
84 Marginal Way
Suite 700
Portland, ME 04101-2443
Phone
(207) 774-5816
Fax
(207) 523-8597
NPI assigned
Jul 23, 2013
Last updated
Jul 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP131047 ME Primary

Addresses

Primary practice location

84 Marginal Way
Suite 700
Portland, ME 04101-2443

Mailing address

100 Foden Rd
Suite 203
South Portland, ME 04106-2327
Phone (207) 828-0361

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP131047MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermed, PA Past Accepting new patients
Intermed, PA Past Accepting new patients
Spectrum Healthcare Partners, P.a. Past Accepting new patients
Intermed, PA PastSince Mar 20, 1991 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDGCAA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1043652779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FODEN RD",
            "address_2": "SUITE 203",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062327",
            "telephone_number": "207-828-0361",
            "fax_number": "207-874-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 MARGINAL WAY",
            "address_2": "SUITE 700",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012443",
            "telephone_number": "207-774-5816",
            "fax_number": "207-523-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESHLEY",
        "first_name": "CAROL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP131047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.