Organization Active NPI

Lynda J Freeland, MD, PLLC

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1891157624
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD014822 Issued in TN
Legal business name
LYNDA J FREELAND, MD, PLLC
Practice address
5210 Poplar Ave
Memphis, TN 38119-3515
Phone
(901) 761-0685
Fax
(901) 761-0688
NPI assigned
Mar 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Authorized official

Name
Patricia McKnatt
Title
Practice Manager
Phone
(901) 634-3545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD014822 TN Primary

Addresses

Primary practice location

5210 Poplar Ave
Memphis, TN 38119-3515

Mailing address

5210 Poplar Ave
Memphis, TN 38119-3515
Phone (901) 761-0685

Other identifiers 1

IdentifierTypeStateIssuer
LJ84OtherTNBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160414001155 TN Part B Supplier - Clinic/Group Practice 2769780329 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

5200 Park Ave
Ste 204
Memphis, TN 38119
Phone (901) 567-5505

5210 Poplar Ave
Memphis, TN 38119
Phone (901) 682-5606

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1891157624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193515",
            "telephone_number": "901-761-0685",
            "fax_number": "901-761-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193515",
            "telephone_number": "901-761-0685",
            "fax_number": "901-761-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNDA J FREELAND, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "MCKNATT",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "901-634-3545"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD014822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "LJ84",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.