Organization Active NPI

Donielle Freedman, M.D. LTD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1093012874
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DONIELLE FREEDMAN, M.D. LTD
Practice address
7336 W Post Rd Ste 109
Las Vegas, NV 89113-6647
Phone
(702) 360-6003
Fax
(702) 360-6006
NPI assigned
Feb 14, 2011
Last updated
Mar 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Authorized official

Name
Sandra Friday
Title
Credentialer
Phone
(702) 800-8988

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

7336 W Post Rd Ste 109
Las Vegas, NV 89113-6647

Mailing address

PO Box 370644
Las Vegas, NV 89137-0644
Phone (702) 360-6003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110616000361 NV Part B Supplier - Clinic/Group Practice 0345428538 Receives reassigned benefits from 4 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1093012874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370644",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891370644",
            "telephone_number": "702-360-6003",
            "fax_number": "702-360-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7336 W POST RD STE 109",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891136647",
            "telephone_number": "702-360-6003",
            "fax_number": "702-360-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONIELLE FREEDMAN, M.D. LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-14",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "FRIDAY",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "702-800-8988"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.