Individual provider Active NPI

Marlys Freese, PT

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1881702884
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
592 Issued in NE
Practice address
4710 Happy Hollow LN
Lincoln, NE 68516-5124
Phone
(402) 416-6810
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 592 NE Primary

Addresses

Primary practice location

4710 Happy Hollow LN
Lincoln, NE 68516-5124

Mailing address

4710 Happy Hollow LN
Lincoln, NE 68516-5124
Phone (402) 416-6810

Other names 1

  • Marlys De Groot Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
592NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Physician Network CurrentSince Apr 30, 2017 Accepting new patients
Lincoln Physician Network LLC Past Accepting new patients

Locations

2683 Solution Ctr
Chicago, IL 60677

2000 Q St
Ste 500
Lincoln, NE 68503
Phone (402) 421-0896

2510 S 40th St
Ste 200
Lincoln, NE 68506
Phone (402) 486-3333

7121 Stephanie Ln
Ste 105
Lincoln, NE 68516
Phone (402) 484-8383

5000 N 26th St
Ste 400
Lincoln, NE 68521
Phone (402) 742-8410

Organizations & group practices 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1881702884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 HAPPY HOLLOW LN",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165124",
            "telephone_number": "402-416-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 HAPPY HOLLOW LN",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165124",
            "telephone_number": "402-416-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREESE",
        "first_name": "MARLYS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLYS",
            "last_name": "DE GROOT",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.

Verify at the official NPI Registry.