Individual provider Active NPI

Annette Freymueller, PHYSICAL THERAPIST

  • Pediatric Physical Therapist
  • Fairbanks, AK
National Provider Identifier
1083812507
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
0831 Issued in AK
Practice address
1258 Viewpointe Dr
Fairbanks, AK 99709-6744
Phone
(907) 479-3550
NPI assigned
Jul 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 0831 AK Primary

Addresses

Primary practice location

1258 Viewpointe Dr
Fairbanks, AK 99709-6744

Mailing address

1258 Viewpointe Dr
Fairbanks, AK 99709-6744
Phone (907) 479-3550

Other identifiers 1

IdentifierTypeStateIssuer
PT0831MedicaidAK

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

State licenses

LicenseStateTypeSpecialty
0831AKMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083812507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 VIEWPOINTE DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997096744",
            "telephone_number": "907-479-3550",
            "fax_number": "907-479-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 VIEWPOINTE DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997096744",
            "telephone_number": "907-479-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREYMUELLER",
        "first_name": "ANNETTE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AK",
            "license": "0831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0831",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.