Individual provider Active NPI

Eleanor Freeman

  • Licensed Practical Nurse
  • Jackson, TN
National Provider Identifier
1497143648
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
0000068887 Issued in TN
Practice address
620 Skyline Drive
Jackson, TN 38302
Phone
(731) 541-5000
NPI assigned
Dec 22, 2014
Last updated
Dec 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0000068887 TN Primary

Addresses

Primary practice location

620 Skyline Drive
Jackson, TN 38302

Mailing address

301 Hurts Chapel Road
Jackson, TN 38301
Phone (731) 313-0974

Other names 1

  • Eleanor Antoine Freeman Professional name

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

State licenses

LicenseStateTypeSpecialty
0000068887TNMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1497143648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HURTS CHAPEL ROAD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38301",
            "telephone_number": "731-313-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DRIVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38302",
            "telephone_number": "731-541-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "ELEANOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "0000068887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEANOR",
            "last_name": "FREEMAN",
            "middle_name": "ANTOINE",
            "credential": "LPN-IV",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.