Individual provider Active NPI

Richard Freeman, M.D.

  • Radiation Oncology Physician
  • Lagrange, GA
National Provider Identifier
1336140607
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
022367 Issued in GA
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

Updated by the provider on Aug 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00273479AMedicaidGA

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
I20161019000570 AL Practitioner - Radiation Oncology 3173692761 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022367GAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The East Alabama Health Care Authority Current Accepting new patients
Eamc ER Physicians CurrentSince Dec 1, 2015 Accepting new patients
The East Alabama Health Care Authority CurrentSince Dec 1, 2015 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

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.181001
  • FHIR API: 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.

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

Verify at the official NPI Registry.