Active NPI
Richard Freeman, M.D.
- Radiation Oncology Physician
- Lagrange, GA
National Provider Identifier
1336140607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 022367
- Practice address
- 111 Medical Dr
Lagrange, GA 30240-4157 - Phone
- (706) 845-3920
- Fax
- (706) 845-3978
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 022367 | GA | Primary |
Addresses
Primary practice location
111 Medical Dr
Lagrange, GA 30240-4157
Mailing address
2864 Johnson Ferry Rd
Suite 150
Marietta, GA 30062-5635
Phone (770) 693-2622
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00273479A | Medicaid | GA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022367 | GA | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The East Alabama Health Care Authority | Current | Accepting new patients | |
| Eamc ER Physicians | Current | Accepting new patients | |
| The East Alabama Health Care Authority | Current | Accepting new patients | |
| Northeast Regional Radiation Oncology Network Inc | Radiation Oncology | Past | Accepting new patients |
Locations
2000 Pepperell Pkwy
Opelika, AL 36801
Phone (334) 364-3300
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.181001
- https://fhir-myrecord.cerner.com/r4/c5013bf3-ebba-4bda-8574-ed83da9e1633/
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Opelika, AL
- NPI 1073685483
-
- Emergency Medical Services (Emergency Medicine) Physician
- Opelika, AL
- NPI 1659541670
-
- Community/Retail Pharmacy
- Opelika, AL
- NPI 1215089305
-
- Radiation Oncology Physician
- Manchester, CT
- NPI 1467516773
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1336140607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2864 JOHNSON FERRY RD",
"address_2": "SUITE 150",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300625635",
"telephone_number": "770-693-2622",
"fax_number": "770-693-6039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MEDICAL DR",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302404157",
"telephone_number": "706-845-3920",
"fax_number": "706-845-3978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "GA",
"license": "022367",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00273479A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.