Individual provider Active NPI

Michelle S. Freeman, M.D.

  • Pediatrics Physician
  • Opelika, AL
National Provider Identifier
1326038431
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
21136 Issued in AL
Practice address
2401 Village Professional Dr S
Opelika, AL 36801-4702
Phone
(334) 749-8121
Fax
(334) 749-6166
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 21136 AL Primary

Addresses

Primary practice location

2401 Village Professional Dr S
Opelika, AL 36801-4702

Mailing address

2401 Village Professional Dr S
Opelika, AL 36801-4702
Phone (334) 749-8121

Other identifiers 1

IdentifierTypeStateIssuer
324973MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160516001699 AL Practitioner - Pediatric Medicine 7719942309 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21136ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan Pediatric Clinic, P. a. Pediatrics CurrentSince Mar 20, 2016 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Columbus Pediatric Associates, PC Past Accepting new patients

Locations

126 Clinic Dr
Dothan, AL 36303
Phone (334) 791-1881

2125 W Roy Parker Rd
Ozark, AL 36360
Phone (334) 445-7337

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12280/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michellefreeman@dpc.allscriptsdirect.net

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1326038431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 VILLAGE PROFESSIONAL DR S",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368014702",
            "telephone_number": "334-749-8121",
            "fax_number": "334-749-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 VILLAGE PROFESSIONAL DR S",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368014702",
            "telephone_number": "334-749-8121",
            "fax_number": "334-749-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "MICHELLE",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "21136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324973",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelika, AL

Sources for this page

Verify at the official NPI Registry.