Individual provider Active NPI

Emma Genevieve Freeze, DC

  • Chiropractor
  • Incline Village, NV
National Provider Identifier
1871287631
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
36331 Issued in CA
Practice address
894 Southwood Blvd
Incline Village, NV 89451-9435
Phone
(775) 831-5544
NPI assigned
Jun 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 36331 CA Primary

Addresses

Primary practice location

894 Southwood Blvd
Incline Village, NV 89451-9435

Mailing address

894 Southwood Blvd
Incline Village, NV 89451-9435
Phone (775) 831-5544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914002168 NV Practitioner - Chiropractic 4385008929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Incline Village Chiropractic LLCGroup PAC ID 0749605087, 2 clinicians

Practice addresses (Care Compare)

894 Southwood Blvd
Incline Village, NV 89451-9435
Phone (775) 831-5544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36331CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Incline Village Chiropractic LLC Chiropractor CurrentSince Aug 1, 2023 Accepting new patients

Locations

894 Southwood Blvd
Incline Vlg, NV 89451
Phone (530) 227-3525

Organizations & group practices 1

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": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1871287631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 SOUTHWOOD BLVD",
            "city": "INCLINE VILLAGE",
            "state": "NV",
            "postal_code": "894519435",
            "telephone_number": "775-831-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 SOUTHWOOD BLVD",
            "city": "INCLINE VILLAGE",
            "state": "NV",
            "postal_code": "894519435",
            "telephone_number": "775-831-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEZE",
        "first_name": "EMMA",
        "middle_name": "GENEVIEVE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "36331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Incline Village, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.