Individual provider Active NPI

Nicholas Scott-Patrick Freeman, D.O.

  • Pulmonary Disease Physician
  • Appleton, WI
National Provider Identifier
1578904884
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
70629-21 Issued in WI
Practice address
1506 S Oneida St
Appleton, WI 54915-1305
Phone
(920) 738-2000
Fax
(920) 223-2070
NPI assigned
Jul 15, 2013
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 011622 OH
Internal Medicine Physician 207R00000X 5101022450 MI
Pulmonary Disease Physician 207RP1001X 70629-21 WI Primary

Addresses

Primary practice location

1506 S Oneida St
Appleton, WI 54915-1305

Mailing address

1506 S Oneida St
Appleton, WI 54915-1305
Phone (920) 738-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20190724003454 WI Practitioner - Pulmonary Disease 0446578686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1506 S Oneida St
Appleton, WI 54915-1305
Phone (920) 738-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101022450MIMDInternal Medicine Physician
70629-21WIMDPulmonary Disease Physician
011622OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jul 16, 2019 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jul 16, 2019 Accepting new patients

Locations

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1578904884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 S ONEIDA ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151305",
            "telephone_number": "920-738-2000",
            "fax_number": "920-223-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 S ONEIDA ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151305",
            "telephone_number": "920-738-2000",
            "fax_number": "920-223-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "NICHOLAS",
        "middle_name": "SCOTT-PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-15",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "011622",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101022450",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "70629-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.