Lori Michele Freetage, DO
Individual provider Active NPI Diagnostic Radiology Physician · Dayton, OH
NPI 1649566829 · NPPES record last updated Feb 15, 2021
Key facts
- NPI
- 1649566829
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 34.014266 (OH)
- Practice address
- 3535 Southern Blvd
Dayton, OH 45429-1221 - Phone
- (201) 741-8875
- NPI assigned
- Jun 25, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kettering Network Radiologists Inc
Practice addresses (Care Compare)
3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8627
416 E Maumee St
Angola, IN 46703-2015
Phone (260) 667-5136
Hospital & facility affiliations
- Kettering Health Main Campus
- Kettering Health Dayton
- Kettering Health Miamisburg
- Soin Medical Center
- Fort Hamilton Hughes Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.41 of 100
- Quality
- 73.46
- Improvement activities
- 40
- Cost
- 73.34
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200526001080 | OH | Practitioner - Diagnostic Radiology | 6709219504 | Reassigns benefits to 2 organizations |
| I20220720003827 | IN | Practitioner - Diagnostic Radiology | 6709219504 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS16627 | FL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kettering Network Radiologists Inc | Diagnostic Radiology | Current |
Accepting new patients |
| Henry County Hospital Inc | Current |
Accepting new patients | |
| Alliance Physicians Inc | Current | Accepting new patients | |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients | |
| Eastpointe Radiologists, PC | Diagnostic Radiology | Past | Accepting new patients |
Locations
416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141
L3402
Columbus, OH 43260
Phone (814) 444-1919
405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200
3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221
3451 Newmark Dr
Miamisburg, OH 45342
Phone (937) 297-6307
Interoperability endpoints
- lfreetage715805@direct.ketteringhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | OS16627 | FL | |
| Diagnostic Radiology Physician | 2085R0202X | 34.014266 | OH | Yes |
Addresses
Primary practice location
3535 Southern Blvd
Dayton, OH 45429-1221
Mailing address
3451 Newmark Dr
Miamisburg, OH 45342-5426
Phone (201) 741-8875
Other practice location 1
6600 Van Aalst Blvd
Fort Benning, GA 31905
Phone (762) 408-2009
Other practice location 2
6600 Van Aalst Blvd
Fort Benning, GA 31905
Phone (762) 408-2009
Other names
- Dr. Lori Michele Hener
Other providers in Dayton, OH
- Lisa Freeman
- Monique N Freeman
- Mykelle Antwanette Freeman
- Victoria Nicole Freeman
- Martha J Freese
- Catherine C French
- Fresh Path Health Solutions LLC
- Fresh Start Behavioral Health Inc
- Fresh Start Behavioral Health Inc
- Lara K Freshwater
All providers in Dayton, OH · Diagnostic Radiology Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.