Active NPI
Patricia Freeman
- Addiction (Substance Use Disorder) Registered Nurse
- Appleton, WI
National Provider Identifier
1902399058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse
- License
- 179696-30
- Practice address
- 3301 N Ballard Rd
Appleton, WI 54911-8928 - Phone
- (920) 753-8816
- NPI assigned
- Jun 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 179696-30 | WI | Primary |
Addresses
Primary practice location
3301 N Ballard Rd
Appleton, WI 54911-8928
Mailing address
PO Box 112
Kimberly, WI 54136-0112
Phone (920) 734-7178
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467503193 | Medicaid | WI |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 179696-30 | WI | MD | Addiction (Substance Use Disorder) Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528848000000",
"number": "1902399058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 112",
"city": "KIMBERLY",
"state": "WI",
"postal_code": "541360112",
"telephone_number": "920-734-7178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 N BALLARD RD",
"city": "APPLETON",
"state": "WI",
"postal_code": "549118928",
"telephone_number": "920-753-8816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "PATRICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-13",
"last_updated": "2018-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WA0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "179696-30",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1467503193",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.