Individual provider Active NPI

Alexis Nicole Freeman, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Waldorf, MD
National Provider Identifier
1225839426
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
L301940 Issued in MD
Practice address
6569 Cluster Pine CT
Waldorf, MD 20603-6706
Phone
(301) 526-4826
NPI assigned
Mar 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal Newborn Registered Nurse 163WM0102X R251284 MD
Lactation Consultant (Registered Nurse) 163WL0100X L301940 MD Primary

Addresses

Primary practice location

6569 Cluster Pine CT
Waldorf, MD 20603-6706

Mailing address

6569 Cluster Pine CT
Waldorf, MD 20603-6706
Phone (301) 526-4826

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
L301940MDMDLactation Consultant (Registered Nurse)
R251284MDMDMaternal Newborn Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1225839426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6569 CLUSTER PINE CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206036706",
            "telephone_number": "301-526-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6569 CLUSTER PINE CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206036706",
            "telephone_number": "301-526-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "ALEXIS",
        "middle_name": "NICOLE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "MD",
            "license": "R251284",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MD",
            "license": "L301940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.