Individual provider Active NPI

Jason Freiberg, PHARM D.

  • Pharmacist
  • Waterloo, IA
National Provider Identifier
1376110007
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19972 Issued in IA
Practice address
2039 Crossroads Blvd Ste B
Waterloo, IA 50702-1215
Phone
(319) 888-1724
NPI assigned
Jun 10, 2021
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19972 IA Primary

Addresses

Primary practice location

2039 Crossroads Blvd Ste B
Waterloo, IA 50702-1215

Mailing address

2039 Crossroads Blvd Ste B
Waterloo, IA 50702-1215
Phone (319) 888-1724

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19972IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
PM Acquisition, LLC PastSince Jun 15, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jfreiberg245303@direct.unitypoint.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1376110007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 CROSSROADS BLVD STE B",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507021215",
            "telephone_number": "319-888-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 CROSSROADS BLVD STE B",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507021215",
            "telephone_number": "319-888-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIBERG",
        "first_name": "JASON",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "19972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.