Active NPI
Mark E Freeman M.D. PC
Doing business as Freeman Plastic Surgery
- Plastic Surgery Physician
- Idaho Falls, ID
National Provider Identifier
1902228737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- M10224
- Legal business name
- MARK E FREEMAN M.D. PC
- Doing business as
- Freeman Plastic Surgery
- Practice address
- 3760 Washington Parkway
Idaho Falls, ID 83404 - Phone
- (208) 881-5351
- NPI assigned
- Jan 14, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mark E Freeman, M.D.
- Title
- President
- Phone
- (208) 881-5351
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | M10224 | ID | Primary |
Addresses
Primary practice location
3760 Washington Parkway
Idaho Falls, ID 83404
Mailing address
3760 Washington Parkway
Idaho Falls, ID 83404
Phone (208) 881-5351
Other names 1
- Freeman Plastic Surgery
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
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": "1389657600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1389657600000",
"number": "1902228737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3760 WASHINGTON PARKWAY",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "83404",
"telephone_number": "208-881-5351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3760 WASHINGTON PARKWAY",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "83404",
"telephone_number": "208-881-5351"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARK E FREEMAN M.D. PC",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-14",
"last_updated": "2014-01-14",
"status": "A",
"authorized_official_last_name": "FREEMAN",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "208-881-5351",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": "ID",
"license": "M10224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Freeman Plastic Surgery",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.