NPIMap

Individual provider Active NPI

Bradley Robert Freidel, D.O.

  • Internal Medicine Physician
  • Macon, MO
National Provider Identifier
1184744765
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
324 Issued in NE
Practice address
1201 N Rutherford St
Macon, MO 63552-2020
Phone
(660) 385-8900
Fax
(660) 385-8708
NPI assigned
Mar 29, 2007
Last updated
Jan 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 324 NE Primary

Addresses

Primary practice location

1201 N Rutherford St
Macon, MO 63552-2020

Mailing address

1201 N Rutherford St
Macon, MO 63552-2020
Phone (660) 385-8900

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
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Moberly Medical Clinics Inc Past Accepting new patients
Pegasus Emergency Group Moberly Past Accepting new patients
Moberly Medical Clinics Inc Past Accepting new patients
Freidel Medical Associates Family Medicine Past Accepting new patients
Wahoo Medical P.C. Past Accepting new patients
Midwest Heart and Vein Center, LLC Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Organizations & group practices 7

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1184744765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N RUTHERFORD ST",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635522020",
            "telephone_number": "660-385-8900",
            "fax_number": "660-385-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N RUTHERFORD ST",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635522020",
            "telephone_number": "660-385-8900",
            "fax_number": "660-385-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIDEL",
        "first_name": "BRADLEY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.