Donald S Freedman MD PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME49644 Issued in FL

Legal business name

DONALD S FREEDMAN MD PA

Doing business as

Northside Medical Clinic

Practice address

480 Busch Dr
Jacksonville, FL 32218-5553

Phone

(904) 764-5000

NPI assigned

Oct 23, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Sharon Minger Wilson, MGR

Title

Office Administrator

Phone

(904) 764-5000

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Northside Medical Clinic Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roderick T Beaman Jr., D.O.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1427002799
  NPD (past)
• Shirley Ann Collins, CNM, ARNP

  • Advanced Practice Midwife
  • Jacksonville, FL
  • NPI 1083684617
  NPD (past)

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1730378043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 BUSCH DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185553",
            "telephone_number": "904-764-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 BUSCH DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185553",
            "telephone_number": "904-764-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD S FREEDMAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "MINGER",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "904-764-5000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MGR"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME 31964",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "FL",
            "license": "OS58811",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME31964",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME49644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF FLORIDA",
            "identifier": "62840",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northside Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jane Donahoo
• Donald a. Barnhorst Jr. MD PA
• Donald B Campbell DC PA
• Donald J Alexander
• Donald L. Smitha, DDS, MDS, PA
• Alicia Michell Donald, RPH
• Jada Donald
• Loretta Donald
• Teresa Donald
• Angela Donaldson, MD

• General Practice Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.