Individual provider Active NPI

Marshall Craig Freeman, MD

  • Neurology Physician
  • Greensboro, NC
National Provider Identifier
1710944756
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2002-00900 Issued in NC
Practice address
1414 Yanceyville Street
First Floor
Greensboro, NC 27405-6930
Phone
(336) 574-8000
Fax
(336) 574-8008
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 200200900 NC
Neurology Physician 2084N0400X 2002-00900 NC Primary

Addresses

Primary practice location

1414 Yanceyville Street
First Floor
Greensboro, NC 27405-6930

Mailing address

1414 Yanceyville Street
First Floor
Greensboro, NC 27405-6930
Phone (336) 574-8000

Other identifiers 2

IdentifierTypeStateIssuer
1313COtherNCBCBSNC
5900990MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040827000323 NC Practitioner - Neurology 7012982689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Wayne State University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1414 Yanceyville St
Suite 1
Greensboro, NC 27405-6930
Phone (336) 574-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200200900NCMDSpecialist
2002-00900NCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Headache Wellness Center PC Specialist CurrentSince Oct 1, 2004 Accepting new patients
Headache Wellness Center PC Specialist Current Accepting new patients

Locations

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

1414 Yanceyville St
Fl First
Greensboro, NC 27405
Phone (336) 574-8000

1414 Yanceyville St
Ste 1
Greensboro, NC 27405
Phone (336) 574-8000

1414 Yanceyville St
Ste 100
Greensboro, NC 27405
Phone 3362174094111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1710944756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 YANCEYVILLE STREET",
            "address_2": "FIRST FLOOR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056930",
            "telephone_number": "336-574-8000",
            "fax_number": "336-574-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 YANCEYVILLE STREET",
            "address_2": "FIRST FLOOR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056930",
            "telephone_number": "336-574-8000",
            "fax_number": "336-574-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "MARSHALL",
        "middle_name": "CRAIG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "200200900",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2002-00900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "1313C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900990",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.