Active NPI
Courtney V Freeman, PA-C
- Physician Assistant
- Maple Grove, MN
National Provider Identifier
1245259043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9682
- Practice address
- 9550 Upland LN N Ste 120
Maple Grove, MN 55369-4481 - Phone
- (763) 537-6000
- Fax
- (763) 537-6666
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9682 | MN | Primary |
Addresses
Primary practice location
9550 Upland LN N Ste 120
Maple Grove, MN 55369-4481
Mailing address
4131 W Loomis Rd Ste 300
Greenfield, WI 53221-2059
Phone (414) 325-7246
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9682 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports & Family Wellness, PLLC | Past | Accepting new patients | |
| Hopkins Spinal Care P.a. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Hopkins, MN
- NPI 1215986757
-
- Medical Specialty Clinic/Center
- Hopkins, MN
- NPI 1982030706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1245259043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4131 W LOOMIS RD STE 300",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532212059",
"telephone_number": "414-325-7246",
"fax_number": "414-325-3770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9550 UPLAND LN N STE 120",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553694481",
"telephone_number": "763-537-6000",
"fax_number": "763-537-6666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "COURTNEY",
"middle_name": "V",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.