Individual provider Active NPI

Ted J Freidline, DC

  • Chiropractor
  • Seymour, IN
National Provider Identifier
1366560823
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001656A Issued in IN
Practice address
600 S Jackson Park Dr
Seymour, IN 47274-2626
Phone
(812) 519-2963
Fax
(812) 519-3515
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001656A IN Primary

Addresses

Primary practice location

600 S Jackson Park Dr
Seymour, IN 47274-2626

Mailing address

600 S Jackson Park Dr
Seymour, IN 47274-2626
Phone (812) 519-2963

Other identifiers 2

IdentifierTypeStateIssuer
000000652140OtherINANTHEM
200091090MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001656AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Central Chiropractic Associates, LLC Chiropractor PastSince Mar 24, 2004 Accepting new patients
Health Centered Chiropractic Chiropractor Past Accepting new patients
Health Centered of Scottsburg, Inc Chiropractor Past Accepting new patients
J Clayton Spine and Health LLC Chiropractor Past Accepting new patients

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1366560823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S JACKSON PARK DR",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742626",
            "telephone_number": "812-519-2963",
            "fax_number": "812-519-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S JACKSON PARK DR",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742626",
            "telephone_number": "812-519-2963",
            "fax_number": "812-519-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIDLINE",
        "first_name": "TED",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001656A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000652140",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200091090",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.