Individual provider Active NPI

Jennifer L Freeman, M.D.

  • Pediatrics Physician
  • Branson, MO
National Provider Identifier
1487684015
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2010031549 Issued in MO
Practice address
1150 State Highway 248
Suite 202
Branson, MO 65616-3758
Phone
(417) 348-8964
Fax
(417) 336-0275
NPI assigned
Jul 3, 2006
Last updated
Sep 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 27666 KS
Pediatrics Physician 208000000X 26612 OK
Pediatrics Physician 208000000X 2010031549 MO Primary

Addresses

Primary practice location

1150 State Highway 248
Suite 202
Branson, MO 65616-3758

Mailing address

PO Box 2150
Lowell, AR 72745-2150
Phone (417) 348-8964

Other identifiers 7

IdentifierTypeStateIssuer
057913OtherKSBCBS
12149433OtherKSMULTIPLAN
100355930AMedicaidKS
109998OtherKSHPK
200212490AMedicaidOK
12721OtherKSPHS
17012OtherKSCOVENTRY

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150428002109 MO Practitioner - Pediatric MedicinePractitioner - Family Practice 3678636073 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27666KSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Sep 5, 2023 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Sep 5, 2023 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Sep 5, 2023 Accepting new patients
Skaggs Community Hospital Association Past Accepting new patients
Mercy Hospital Springfield Past Accepting new patients

Locations

505 N 25th St
Ozark, MO 65721
Phone (417) 581-3548

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

3231 S National Ave
Ste 100
Springfield, MO 65807
Phone (417) 841-0116

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

Organizations & group practices 5

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1487684015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2150",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727452150",
            "telephone_number": "417-348-8964",
            "fax_number": "417-336-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 STATE HIGHWAY 248",
            "address_2": "SUITE 202",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656163758",
            "telephone_number": "417-348-8964",
            "fax_number": "417-336-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "27666",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "26612",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2010031549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "057913",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "12149433",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100355930A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPK",
            "identifier": "109998",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200212490A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHS",
            "identifier": "12721",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "17012",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.