Martha J Freese, BA

Key facts

NPI

1427675172

Entity type

Individual (NPI type 1)

Primary specialty

Case Manager/Care Coordinator 171M00000X

Practice address

2555 S Dixie Dr Ste 260
Dayton, OH 45409-1542

Phone

(937) 853-9061

Fax

(937) 853-9069

NPI assigned

Jun 29, 2020

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Bachelor of Arts

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 29, 2020.

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1427675172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 ELIDA RD",
            "city": "DELPHOS",
            "state": "OH",
            "postal_code": "458339056",
            "telephone_number": "419-695-8010",
            "fax_number": "419-695-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 S DIXIE DR STE 260",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454091542",
            "telephone_number": "937-853-9061",
            "fax_number": "937-853-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREESE",
        "first_name": "MARTHA",
        "middle_name": "J",
        "credential": "BA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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