Individual provider Active NPI

Glenda McDaniel Freeman, RPT

  • Physical Therapy Clinic/Center
  • Birmingham, AL
National Provider Identifier
1174821045
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PTH1123 Issued in AL
Practice address
2807 Greystone Commercial Blvd
Suite 34
Birmingham, AL 35242-9600
Phone
(205) 745-3650
NPI assigned
Mar 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PTH1123 AL Primary

Addresses

Primary practice location

2807 Greystone Commercial Blvd
Suite 34
Birmingham, AL 35242-9600

Mailing address

2038 Country Ridge Cir
Vestavia, AL 35243-4308
Phone (205) 967-4777

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
PTH1123ALMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy South Pelham, LLC Physical Therapy PastSince Jun 1, 2012 Accepting new patients

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": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1174821045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2038 COUNTRY RIDGE CIR",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352434308",
            "telephone_number": "205-967-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 GREYSTONE COMMERCIAL BLVD",
            "address_2": "SUITE 34",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352429600",
            "telephone_number": "205-745-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "GLENDA",
        "middle_name": "MCDANIEL",
        "name_prefix": "Mrs.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AL",
            "license": "PTH1123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.