Matthew Lynn Freeman, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1384 Issued in OK

Practice address

RR 6 Box 840
Stilwell, OK 74960-8703

Phone

(918) 696-8800

Fax

(918) 696-3879

NPI assigned

Oct 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/

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.

• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Tahlequah, OK
  • NPI 1093722324
  NPD (past)
• Northeastern State University College of Optometry

  • Optometrist
  • Tahlequah, OK
  • NPI 1437106333
  NPD (past)
• East Texas Medical Center Healthcare Associates

  • Emergency Medicine Physician
  • Tyler, TX
  • NPI 1326082892
  NPD (past)
• East Texas Medical Center Healthcare Associates

  • Emergency Medicine Physician
  • Tyler, TX
  • NPI 1699719872
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1275520165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 E SHARON ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036599",
            "telephone_number": "479-251-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 6 BOX 840",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749608703",
            "telephone_number": "918-696-8800",
            "fax_number": "918-696-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "MATTHEW",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA1384",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02983",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1601384",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alivia Fletcher, MS
• Fort Smith Regional Dialysis, LLC
• Karen Fourkiller, M.ED., SLP-CCC
• Marquana Fourkiller, LPN
• Ruth Ann Fourkiller
• Jericho Garr
• Sarah Elizabeth Garrett
• Amy Renee Gifford, MS LPC
• Debrah J Goff
• Grand Lake Mental Health Center, Inc.

• Medical Physician Assistant in Stilwell, OK
• Providers in Stilwell, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.