Mary Lou Freitag

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

202010537NP-PP Issued in OR

Practice address

324 4TH St
Myrtle Point, OR 97458-1074

Phone

(541) 572-2111

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Coquille Valley HealthGroup PAC ID 2567902182, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Coast Hospice Hospice, Coos Bay, OR, CCN 381530
• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090
• Lower Umpqua Hospital District Hospital, Reedsport, OR, CCN 381311
• Coquille Valley Hospital Hospital, Coquille, OR, CCN 381312
• Southern Coos Hospital & Health Center Hospital, Bandon, OR, CCN 381304

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/5c5c3b5c-6128-40bc-b71b-102ccb82d7e7/

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.

• Coquille Valley Health

  • Orthopaedic Surgery Physician
  • Coos Bay, OR
  • NPI 1376374967
  Medicare reassignment Care Compare group NPD
• Coquille Valley Hospital District

  • Critical Access Hospital
  • Coquille, OR
  • NPI 1730223967
  Medicare reassignment NPD
• North Bend Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Coos Bay, OR
  • NPI 1407812365
  Medicare reassignment NPD
• Coquille Valley Health

  • Critical Access Hospital
  • Coquille, OR
  • NPI 1932080199
  NPD
• Coquille Valley Hospital District

  • Medicare Defined Swing Bed Hospital Unit
  • Coquille, OR
  • NPI 1164557179
  NPD
• North Bend Medical Center Inc

  • Diagnostic Radiology Physician
  • Coos Bay, OR
  • NPI 1063428308
  NPD
• Coquille Valley Health

  • Family Medicine Physician
  • Myrtle Point, OR
  • NPI 1306623657
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bay Area Hospital District

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation
• Coquille Valley Hospital District

  • Critical Access Hospital
  • Coquille, OR
  • NPI 1730223967
  Care Compare affiliation
• Lower Umpqua Hospital District

  • Critical Access Hospital
  • Reedsport, OR
  • NPI 1003874819
  Care Compare affiliation
• South Coast Hospice & Palliative Care Services Inc

  • Community Based Hospice Care Agency
  • Coos Bay, OR
  • NPI 1417956558
  Care Compare affiliation
• Southern Coos Health District

  • Critical Access Hospital
  • Bandon, OR
  • NPI 1588684484
  Care Compare affiliation

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1962090621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202099",
            "telephone_number": "541-267-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 4TH ST",
            "city": "MYRTLE POINT",
            "state": "OR",
            "postal_code": "974581074",
            "telephone_number": "541-572-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREITAG",
        "first_name": "MARY LOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202010537NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500789478",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of Coos Myrtle Point School District 41
• Margo Jo Day, LPN
• Allison Ehrlich
• Jordan Ehrlich
• Ana Marie Ferguson, FNP-C
• James Robert Gronemyer, DDS
• Edmund Reed Gurney Jr., MD
• David Yim Lee, MD
• Myrtle Point of Cascadia, LLC
• New Creations LLC 1111

• Nurse Practitioner in Myrtle Point, OR
• Providers in Myrtle Point, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.