Individual provider Active NPI

Rhiannon Freiberg, NP

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1801289459
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007308 Issued in MI
Practice address
3355 Eagle Park Dr NE Ste 103
Grand Rapids, MI 49525-7004
Phone
(616) 942-7400
Fax
(616) 942-7405
NPI assigned
Mar 6, 2015
Last updated
Apr 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007308 MI Primary

Addresses

Primary practice location

3355 Eagle Park Dr NE Ste 103
Grand Rapids, MI 49525-7004

Mailing address

3355 Eagle Park Dr NE Ste 103
Grand Rapids, MI 49525-7004
Phone (616) 942-7400

Other practice location 1

917 W Milham Ave
Portage, MI 49024
Phone (269) 567-9806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150330001913 MI Practitioner - Physician Assistant 3779800867 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007308MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince May 1, 2019 Accepting new patients
Vpa PC CurrentSince May 1, 2019 Accepting new patients

Locations

4444 W Bristol Rd
Ste 150
Flint, MI 48507
Phone (810) 230-9500

3355 Eagle Park Dr NE
Ste 103
Grand Rapids, MI 49525
Phone (616) 942-7400

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

2725 Airview Blvd
Ste 105
Portage, MI 49002
Phone (269) 349-8386

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

Organizations & group practices 5

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": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1801289459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 EAGLE PARK DR NE STE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257004",
            "telephone_number": "616-942-7400",
            "fax_number": "616-942-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 EAGLE PARK DR NE STE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257004",
            "telephone_number": "616-942-7400",
            "fax_number": "616-942-7405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "917 W Milham Ave",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "49024",
            "country_code": "US",
            "telephone_number": "269-567-9806",
            "fax_number": "269-567-9808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREIBERG",
        "first_name": "RHIANNON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-06",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.