Individual provider Active NPI

Annie Rose Howell-Freckleton, ANP

  • Nurse Practitioner
  • Tucker, GA
National Provider Identifier
1679981211
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN183877 Issued in GA
Practice address
1462 Montreal Road
Suite 201
Tucker, GA 30084-6931
Phone
(678) 580-6931
Fax
(770) 807-0978
NPI assigned
Jul 28, 2014
Last updated
May 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN183877 GA Primary
Family Nurse Practitioner 363LF0000X RN183877 GA

Addresses

Primary practice location

1462 Montreal Road
Suite 201
Tucker, GA 30084-6931

Mailing address

1462 Montreal Road
Suite 201
Tucker, GA 30084-6931
Phone (678) 580-6931

Other identifiers 2

IdentifierTypeStateIssuer
003156391AMedicaidGA
003156391DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141201001484 GA Practitioner - Nurse Practitioner 5597087643 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN183877GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Hospice of Georgia, LLC CurrentSince Nov 27, 2017 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Nurse Practitioner CurrentSince Apr 1, 2022 Accepting new patients
Peachtree Hospice of Georgia, LLC Past Accepting new patients

Locations

135 Gemini Cir
Ste 202
Birmingham, AL 35209
Phone (205) 949-0400

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

1395 S Marietta Pkwy SE
Ste 116
Marietta, GA 30067
Phone (678) 932-6302

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

1233 Eagles Landing Pkwy
Ste Ab
Stockbridge, GA 30281
Phone (404) 480-3842

354 Corporate Center Ct
Stockbridge, GA 30281
Phone (678) 583-2269

2460 Washington Rd
Thomson, GA 30824
Phone (706) 595-1411

Organizations & group practices 3

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": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1679981211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 MONTREAL ROAD",
            "address_2": "SUITE 201",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846931",
            "telephone_number": "678-580-6931",
            "fax_number": "770-807-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 MONTREAL ROAD",
            "address_2": "SUITE 201",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846931",
            "telephone_number": "678-580-6931",
            "fax_number": "770-807-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWELL-FRECKLETON",
        "first_name": "ANNIE",
        "middle_name": "ROSE",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN183877",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN183877",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003156391A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003156391D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.