Marshall Cornelius Freerks Jr., DDS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

14600 Issued in MO

Practice address

6744 Clayton Rd.
Suite 204
St. Louis, MO 63117-1634

Phone

(314) 725-5515

NPI assigned

Jan 30, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233273600000",
    "number": "1346488236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6744 CLAYTON RD.",
            "address_2": "SUITE 204",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631171634",
            "telephone_number": "314-725-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6744 CLAYTON RD.",
            "address_2": "SUITE 204",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631171634",
            "telephone_number": "314-725-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREERKS",
        "first_name": "MARSHALL",
        "middle_name": "CORNELIUS",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "14600",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MO",
            "license": "14600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam Freeman, OD
• Tkaila Freeman
• William Emmett Freeman Jr., MD
• James Matthew Freer, MD
• Phoebe Elizabeth Freer, M.D.
• Cindy Ann Freese
• Jennifer L Freese, RDH
• Kathryn Kay Freese, FNP
• Charles G Freesmeier, MSW, LCSW
• Katelynn Joy Frei

• Dental Clinic/Center in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.

Verify at the official NPI Registry.