Active NPI
Larry S Freeman, MD
- Child & Adolescent Psychiatry Physician
- Bellingham, WA
National Provider Identifier
1609956564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD00016788
- Practice address
- 119 N Commercial St
Suite 1360
Bellingham, WA 98225-4446 - Phone
- (360) 752-5527
- Fax
- (360) 752-5543
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD00016788 | WA | Primary |
Addresses
Primary practice location
119 N Commercial St
Suite 1360
Bellingham, WA 98225-4446
Mailing address
119 N Commercial St
Suite 1360
Bellingham, WA 98225-4446
Phone (360) 752-5527
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1430602 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2023 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00016788 | WA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609956564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 N COMMERCIAL ST",
"address_2": "SUITE 1360",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982254446",
"telephone_number": "360-752-5527",
"fax_number": "360-752-5543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 N COMMERCIAL ST",
"address_2": "SUITE 1360",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982254446",
"telephone_number": "360-752-5527",
"fax_number": "360-752-5543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "LARRY",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "WA",
"license": "MD00016788",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1430602",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.