DR. BRADLEY ROBERT FREIDEL (NPI# 1184744765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184744765 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY ROBERT FREIDEL |
| Credential | D.O. |
| Practice Address |
1201 N Rutherford St Macon MO 63552-2020 |
| Practice Telephone | 6603858900 |
| Practice Fax Number | 6603858708 |
| Mailing Telephone | 6603858900 |
| Mailing Fax Number | 6603858708 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2013-01-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 324 | NE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | RAILROAD MEDICARE | P00128031 | 01 |
| NE | UNITED HEALTHCARE | 200652429 | 01 |
| NE | 200652429 | 05 | |
| NE | TRICARE PROVIDER | 20065242968066 | 01 |
| NE | BLUE CROSS PROVIDER # | 07035 | 01 |
| NE | MIDLANDS CHOICE | 235966 | 01 |
| Street Address |
1201 N RUTHERFORD ST |
| City | MACON |
| State | MO |
| Zip Code | 63552-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750387163 | Nora Marie Hockman-mcdowell | Nurse Practitioner | 1201 N Rutherford St, Macon, MO 63552-2020 | 2005-06-22 |
| 1942845375 | Emily Kerns | Physician Assistant | 1201 N Rutherford St, Macon, MO 63552-2020 | 2019-11-08 |
| 1508417650 | Jamie Lynne Oliver | Nurse Practitioner | 1201 N Rutherford St, Macon, MO 63552-2020 | 2019-09-20 |
| 1437666872 | Macon County Samaritan Hospital | Clinic/Center | 1201 N Rutherford St, Macon, MO 63552-2020 | 2018-01-08 |
| 1437552213 | Krystal Barnett | Nurse Practitioner | 1201 N Rutherford St, Macon, MO 63552-2020 | 2014-10-07 |
| 1558651794 | Lisa Michelle Mayes | Family Medicine | 1201 N Rutherford St, Macon, MO 63552-2020 | 2011-04-08 |
| 1114195187 | Paula G Barr | Nurse Practitioner | 1201 N Rutherford St, Macon, MO 63552-2020 | 2008-02-13 |
| 1891734505 | Macon County Samaritan Hospital | Clinic/Center | 1201 N Rutherford St, Macon, MO 63552-2020 | 2006-06-06 |
| 1952340663 | Julie L Burdin | Family Medicine | 1201 N Rutherford St, Macon, MO 63552-2020 | 2006-06-06 |
| 1255370482 | James W Mcdowell | Family Medicine | 1201 N Rutherford St, Macon, MO 63552-2020 | 2006-06-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891194783 | Dialysis Clinic Inc | Clinic/Center | 1203 N. Missouri St, Macon, MO 63552 | 2014-08-18 |
| 1477624161 | Charles Edgar Averill Jr. | Occupational Therapist | 704a South Missouri, Macon, MO 63552 | 2006-11-13 |
| 1629035084 | Missouri Cvs Pharmacy, L.L.C. | Pharmacy | 1105 N Rutherford St, Macon, MO 63552 | 2006-04-28 |
| 1659560688 | Iris Ladawn Gaerditz | Speech-Language Pathologist | 702 N Missouri St, Macon, MO 63552 | 2007-10-16 |
| 1841316296 | Paul Vincent Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-03-21 |
| 1891908612 | Mid Missouri Physical Therapy | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-05-08 |
| 1366568735 | Lara Beth Jones | Physical Therapist | 2005 N. Missouri St., Suite D., Macon, MO 63552-0381 | 2007-03-21 |
| 1871619262 | Abby M Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0387 | 2007-03-21 |
| 1457715906 | Kimberly Oroke | Social Worker | 821 Charles St, Columbia, MO 63552-1064 | 2016-04-11 |
| 1679100507 | Macon County Sheltered Workshop | Private Vehicle | 1103 Enterprise Rd, Macon, MO 63552-1305 | 2020-03-23 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174011811 | Frances Barnes Grant | Internal Medicine | 1842 Waverland Cir, Macon, GA 31211-1116 | 2018-04-27 |
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1598295719 | Lori Starr | Internal Medicine | 446 Poplar St Ste B, Macon, GA 31201-3336 | 2017-06-20 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1720456163 | Wellness Connect | Internal Medicine | 1209 Marlowe Dr, Macon, GA 31210-3107 | 2015-09-02 |
| 1396157657 | Almatmed H Mohamed Abdelsalam | Internal Medicine | 657 Hemlock St Ste 220, Macon, GA 31201-8311 | 2014-05-21 |
| 1114369865 | Douglas Farman Md LLC | Internal Medicine | 310 Hospital Dr Ste 320, Macon, GA 31217-8027 | 2013-07-23 |
| 1528328796 | Ahmad Azmi Kabbani | Internal Medicine | 640 Martin Luther King Jr Blvd Ste 200, Macon, GA 31201-3297 | 2012-05-22 |
| 1376772640 | Beverly Barksdale Sanders IIi | Internal Medicine | 330 Hospital Dr., Ste. 304, Macon, GA 31217 | 2009-07-08 |
| 1649414657 | Lillette A Intaphan Md LLC | Internal Medicine | 432 Poplar St, Suite B, Macon, GA 31201-3336 | 2009-04-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.