Individual provider Active NPI

John Thomas Friedland, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Fort Leonard Wood, MO
National Provider Identifier
1689654345
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
P1302 Issued in TX
Practice address
4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098
Phone
(573) 596-0035
NPI assigned
Jan 19, 2006
Last updated
Mar 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X P1302 TX Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X 42090 KY
Orthopaedic Surgery of the Spine Physician 207XS0117X 45264 TN

Addresses

Primary practice location

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098

Mailing address

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098
Phone (573) 596-0035

Other identifiers 3

IdentifierTypeStateIssuer
8X7651OtherTXBCBS
1187713OtherTXCIGNA
7756093OtherTXAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20090806000817 TN Practitioner - Orthopedic Surgery 2668474230 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42090KYMDOrthopaedic Surgery of the Spine Physician
P1302TXMDOrthopaedic Surgery of the Spine Physician
TP981KYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Southern Tennessee LLC CurrentSince Oct 1, 2014 Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Oct 1, 2014 Accepting new patients
Orthopaedic & Spine Institute LLC Past Accepting new patients
Louisville Orthopaedic Clinic & Sports Rehabilitation Center PSC Past Accepting new patients
Tennessee Heart and Lung Institute PLC Past Accepting new patients
Clarksville Physician Services, LLC Past Accepting new patients

Locations

300 S Main St
Estill Springs, TN 37330
Phone (931) 649-5139

185 Hospital Rd
Winchester, TN 37398
Phone (931) 962-4061

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

Organizations & group practices 6

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1689654345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDLAND",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "P1302",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "KY",
            "license": "42090",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TN",
            "license": "45264",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8X7651",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1187713",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7756093",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leonard Wood, MO

Sources for this page

Verify at the official NPI Registry.