Individual provider Active NPI

Steven L Friesen, M.D.

  • Pediatrics Physician
  • Ashland, OH
National Provider Identifier
1588668404
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35079410 Issued in OH
Practice address
1522 Claremont Ave
Ashland, OH 44805-3533
Phone
(419) 207-1085
Fax
(419) 207-0607
NPI assigned
Jun 9, 2005
Last updated
Feb 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35079410 OH Primary

Addresses

Primary practice location

1522 Claremont Ave
Ashland, OH 44805-3533

Mailing address

1522 Claremont Ave
Ashland, OH 44805-3533
Phone (419) 207-1085

Other identifiers 2

IdentifierTypeStateIssuer
000000224138OtherOHBLUE CROSS BLUE SHIELD PI
2320983MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20141002000667 OH Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0042430621

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35079410OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 1

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1588668404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 CLAREMONT AVE",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448053533",
            "telephone_number": "419-207-1085",
            "fax_number": "419-207-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 CLAREMONT AVE",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448053533",
            "telephone_number": "419-207-1085",
            "fax_number": "419-207-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESEN",
        "first_name": "STEVEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35079410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PI",
            "identifier": "000000224138",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2320983",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OH

Sources for this page

Verify at the official NPI Registry.