Individual provider Active NPI

Douglas Lynn Friesen, MD

  • Surgery Physician
  • Rogers, AR
National Provider Identifier
1962460519
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
N8205 Issued in AR
Practice address
2708 S Rife Medical LN Ste T40
Rogers, AR 72758-1474
Phone
(479) 878-2550
Fax
(479) 878-2555
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X N8205 AR Primary

Addresses

Primary practice location

2708 S Rife Medical LN Ste T40
Rogers, AR 72758-1474

Mailing address

PO Box 1515
Durant, OK 74702-1515
Phone (580) 920-2525

Other identifiers 1

IdentifierTypeStateIssuer
121430001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110117000077 AR Practitioner - General SurgeryPractitioner - Undersea and Hyperbaric Medicine 2769554021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Medical Services, PLLC CurrentSince Jul 15, 2013 Accepting new patients
Mercy Health Northwest Arkansas Communities Past Accepting new patients

Locations

1 Saint Vincent Cir
Little Rock, AR 72205
Phone (479) 878-2250

1194 W Walnut St
Rogers, AR 72756
Phone (479) 878-2250

2708 S Rife Medical Ln
Ste T40
Rogers, AR 72758
Phone (479) 338-4000

Interoperability endpoints

  • Direct secure messaging: dfriesen17151@directc.mercy.net

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1962460519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1515",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747021515",
            "telephone_number": "580-920-2525",
            "fax_number": "580-924-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 S RIFE MEDICAL LN STE T40",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581474",
            "telephone_number": "479-878-2550",
            "fax_number": "479-878-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESEN",
        "first_name": "DOUGLAS",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "N8205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121430001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.