John C Freeman, MEDICAL DOCTOR-MD
Individual provider Active NPI Pediatrics Physician · Nampa, ID
NPI 1437279031 · NPPES record last updated Mar 5, 2024
Key facts
- NPI
- 1437279031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- M10239 (ID)
- Practice address
- 1510 12TH Ave Rd
Nampa, ID 83686-6008 - Phone
- (208) 302-6800
- Fax
- (208) 302-6855
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Saint Louis University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Saint Alphonsus Regional Medical Center Inc
Practice addresses (Care Compare)
1510 12TH Ave Rd
Suite 200
Nampa, ID 83686-6008
Phone (208) 302-6899
1512 12TH Ave Rd
Suite 100
Nampa, ID 83686-6008
Phone (208) 467-1171
3025 W Cherry LN
Meridian, ID 83642-8531
Hospital & facility affiliations
- Saint Alphonsus Regional Medical Center
- Saint Alphonsus Medical Center - Nampa
- St Luke'S Nampa Medical Center
- St Luke'S Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080913000052 | ID | Practitioner - Pediatric Medicine | 3577639699 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M10239 | ID | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | Current |
Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Current | Accepting new patients | |
| Southern Idaho Health Partners LLC | Current |
Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Internal Medicine | Current |
Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400
3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400
520 S Eagle Rd
Ste 2116
Meridian, ID 83642
Phone (208) 884-2999
215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234
4403 E Flamingo Ave
Nampa, ID 83687
Phone (208) 288-4960
1510 12th Ave Rd
Ste 200
Nampa, ID 83686
Phone (208) 302-0600
217 W Georgia Ave
Ste 115
Nampa, ID 83686
Phone (208) 463-3234
Interoperability endpoints
- jfreeman3234307@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | M10239 | ID | |
| Pediatrics Physician | 208000000X | M10239 | ID | Yes |
Addresses
Primary practice location
1510 12TH Ave Rd
Nampa, ID 83686-6008
Mailing address
PO Box 190930
Boise, ID 83719-0930
Phone (208) 302-9342
Other practice location 1
215 E Hawaii Ave
Nampa, ID 83686-6011
Phone (208) 463-3234
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00652182 | Other | RAILROAD MEDICARE | |
| 8080229 | Medicaid | ID |
Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.