Active NPI
Adrianna Mailyn Freeman, RBT
- Behavior Technician
- Fairbanks, AK
National Provider Identifier
1740833789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3568 Geraghty Ave
Fairbanks, AK 99709-4701 - Phone
- (907) 374-7001
- NPI assigned
- Jul 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
3568 Geraghty Ave
Fairbanks, AK 99709-4701
Mailing address
3568 Geraghty Ave
Fairbanks, AK 99709-4701
Phone (907) 374-7001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1991904 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596585600000",
"number": "1740833789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3568 GERAGHTY AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997094701",
"telephone_number": "907-374-7001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3568 GERAGHTY AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997094701",
"telephone_number": "907-374-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "ADRIANNA",
"middle_name": "MAILYN",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-18",
"last_updated": "2020-08-05",
"certification_date": "2020-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1991904",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.