Individual provider Active NPI

Bonnie Lee Freeland, NP

  • Family Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1194784595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R24760 Issued in ND
Practice address
McCannel Hall Room 100
2891 2ND Avenue North Stop 9038
Grand Forks, ND 58202-9038
Phone
(701) 777-4500
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

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
Family Nurse Practitioner 363LF0000X R24760 ND Primary

Addresses

Primary practice location

McCannel Hall Room 100
2891 2ND Avenue North Stop 9038
Grand Forks, ND 58202-9038

Mailing address

McCannel Hall Room 100
2891 2ND Avenue North Stop 9038
Grand Forks, ND 58202-9038
Phone (701) 777-4500

Other identifiers 1

IdentifierTypeStateIssuer
19581MedicaidND

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R24760NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University North Dakota Past Accepting new patients
University of North Dakota Past Accepting new patients
University of North Dakota Center for Sports Medicine Past Accepting new patients

Organizations & group practices 3

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194784595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MCCANNEL HALL ROOM 100",
            "address_2": "2891 2ND AVENUE NORTH STOP 9038",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582029038",
            "telephone_number": "701-777-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MCCANNEL HALL ROOM 100",
            "address_2": "2891 2ND AVENUE NORTH STOP 9038",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582029038",
            "telephone_number": "701-777-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREELAND",
        "first_name": "BONNIE",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R24760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19581",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

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.