Individual provider Active NPI

Ellen D Freed, CRNP

  • Family Nurse Practitioner
  • West Chester, PA
National Provider Identifier
1104870062
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
UP003009B Issued in PA
Practice address
West Chester University
Student Health and Wellness Center
West Chester, PA 19383-0001
Phone
(610) 436-2509
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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 UP003009B PA Primary

Addresses

Primary practice location

West Chester University
Student Health and Wellness Center
West Chester, PA 19383-0001

Mailing address

125 Rodney Cir
Bryn Mawr, PA 19010-3727
Phone (610) 519-0856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080616000676 PA Practitioner - Nurse Practitioner 0749351963 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
UP003009BPAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Treatment Network LLC CurrentSince Feb 1, 2023 Accepting new patients

Locations

1120 W Township Line Rd
Ste 200
Havertown, PA 19083
Phone (484) 451-8313

1120 W Township Line Rd
Fl 2
Havertown, PA 19083
Phone (484) 535-1231

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1104870062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 RODNEY CIR",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103727",
            "telephone_number": "610-519-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WEST CHESTER UNIVERSITY",
            "address_2": "STUDENT HEALTH AND WELLNESS CENTER",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193830001",
            "telephone_number": "610-436-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREED",
        "first_name": "ELLEN",
        "middle_name": "D",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "UP003009B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.