NPIMap

Organization Active NPI

Freedman Clinic of Internal Medicine, LLP

  • Internal Medicine Physician
  • Alexandria, LA
National Provider Identifier
1831180637
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FREEDMAN CLINIC OF INTERNAL MEDICINE, LLP
Practice address
176 Versailles Blvd
Alexandria, LA 71303-2493
Phone
(318) 445-9331
Fax
(318) 619-6899
NPI assigned
Oct 31, 2005
Last updated
Sep 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
Alexis Hill Terrell
Title
Ehr Supervisor
Phone
(318) 445-9331

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Gastroenterology Physician 207RG0100X NU
Infectious Disease Physician 207RI0200X NU
Nephrology Physician 207RN0300X NU
Pediatrics Physician 208000000X NU
Nurse Practitioner 363L00000X NU
Sleep Medicine (Internal Medicine) Physician 207RS0012X NU

Addresses

Primary practice location

176 Versailles Blvd
Alexandria, LA 71303-2493

Mailing address

PO Box 13030
Alexandria, LA 71315-3030
Phone (318) 445-9331

Other identifiers 1

IdentifierTypeStateIssuer
1111147MedicaidLA

Other names 1

  • FREEDMAN PERDUE & GODLEY & MORRISON PTR Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031203000085 LA Part B Supplier - Clinic/Group Practice 0345145447 Receives reassigned benefits from 21 practitioners
Practice locations: Alexandria, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0464721Freedman Clinic of Internal Medicine176 Versailles Blvd, Alexandria, LA 71303AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Locations

1337 Centre Ct
Alexandria, LA 71301
Phone (318) 445-9331

1635 Carter St
Vidalia, LA 71373
Phone (318) 414-9336

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIBADA

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1831180637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13030",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713153030",
            "telephone_number": "318-445-9331",
            "fax_number": "318-619-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 VERSAILLES BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032493",
            "telephone_number": "318-445-9331",
            "fax_number": "318-619-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDMAN CLINIC OF INTERNAL MEDICINE, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "TERRELL",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_middle_name": "HILL",
        "authorized_official_title_or_position": "EHR SUPERVISOR",
        "authorized_official_telephone_number": "318-445-9331"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1111147",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREEDMAN PERDUE & GODLEY & MORRISON PTR",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "FREEDMAN PERDUE & GODLEY & MORRISON PTR",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.