Individual provider Active NPI

Haley Miranda Freeman

  • Pediatric Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1740765940
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
PENDING Issued in TN
Practice address
848 Adams Ave.
Ste. L400
Memphis, TN 38103
Phone
(901) 287-7337
Fax
(901) 287-4540
NPI assigned
Oct 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X PENDING TN Primary

Addresses

Primary practice location

848 Adams Ave.
Ste. L400
Memphis, TN 38103

Mailing address

850 Poplar Ave BLDG 2
Memphis, TN 38105-4607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190220002988 TN Practitioner - Nurse Practitioner 3274871025 Reassigns benefits to 1 organization
I20250822000780 MS Practitioner - Nurse Practitioner 3274871025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Ear Nose and Throat PCGroup PAC ID 3779568092, 32 clinicians

Practice addresses (Care Compare)

7164 Hacks Cross Rd
Suite 105 106
Olive Branch, MS 38654-4472
Phone (901) 755-5300

7600 Wolf River Blvd
Suite 220
Germantown, TN 38138-1788
Phone (901) 755-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
PENDINGTNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Ear, Nose, and Throat, P.C. CurrentSince Jun 9, 2025 Accepting new patients
Mid-South Ear, Nose, and Throat, P.C. CurrentSince Jun 9, 2025 Accepting new patients
North Internal Medicine, P. C. PastSince Nov 9, 2020 Accepting new patients

Locations

7164 Hacks Cross Rd
Ste 105106
Olive Branch, MS 38654

7164 Hacks Cross Rd
Ste 105
Olive Branch, MS 38654

7378 Yale Rd
Bartlett, TN 38133
Phone (901) 387-0193

7600 Wolf River Blvd
Ste 220
Germantown, TN 38138

7600 Wolf River Blvd
Ste 120
Germantown, TN 38138

Interoperability endpoints

  • Direct secure messaging: hfreeman26529@mlh.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1740765940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE BLDG 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 ADAMS AVE.",
            "address_2": "STE. L400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38103",
            "telephone_number": "901-287-7337",
            "fax_number": "901-287-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "HALEY",
        "middle_name": "MIRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.