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  7. NPI Record 1518996867

LIBERTY FREEMAN O.T.
Complete NPI Record 1518996867
Specialist in Mobile, AL

NPI Status: Active since June 30, 2006

Contact Information

4715 AIRPORT BLVD STE 310
MOBILE, AL
ZIP 36608
Phone: (251) 344-4212
Fax: (251) 344-4302

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Credential Text
  6. Provider First Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider Business Mailing Address Fax Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Business Practice Location Address Fax Number
  20. Provider Enumeration Date
  21. Last Update Date
  22. Provider Gender Code
  23. Healthcare Provider Taxonomy Code 1
  24. Provider License Number 1
  25. Provider License Number State Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Other Provider Identifier 1
  28. Other Provider Identifier Type Code 1
  29. Other Provider Identifier State 1
  30. Other Provider Identifier Issuer 1
  31. Other Provider Identifier 2
  32. Other Provider Identifier Type Code 2
  33. Other Provider Identifier State 2
  34. Other Provider Identifier Issuer 2
  35. Other Provider Identifier 3
  36. Other Provider Identifier Type Code 3
  37. Other Provider Identifier State 3
  38. Other Provider Identifier Issuer 3
  39. Other Provider Identifier 4
  40. Other Provider Identifier Type Code 4
  41. Other Provider Identifier State 4
  42. Other Provider Identifier Issuer 4
  43. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1518996867. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1518996867
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: LIBERTY
The first name of the provider, if the provider is an individual.
Provider Credential Text: O.T.
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Provider First Line Business Mailing Address: 4715 AIRPORT BLVD STE 310
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Business Mailing Address City Name: MOBILE
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Business Mailing Address State Name: AL
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Business Mailing Address Postal Code: 366083181
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 2513444212
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 2513444302
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider First Line Business Practice Location Address: 4715 AIRPORT BLVD STE 310
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MOBILE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: AL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 366083181
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Practice Location Address Country Code If outside U S : US
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Business Practice Location Address Telephone Number: 2513444212
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 2513444302
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/30/2006
The State code in the location of the provider being identified.
Last Update Date: 9/16/2013
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 174400000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 1714
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: AL
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
The date that a record was last updated or changed.
Other Provider Identifier 1: 515-29231
The code designating the provider’s gender if the provider is a person.
Other Provider Identifier Type Code 1: 01
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Other Provider Identifier State 1: AL
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Other Provider Identifier Issuer 1: BCBS
Other Provider Identifier 2: 515-42913
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: AL
Other Provider Identifier Issuer 2: BCBS DAPNE, AL. LOCATION
Other Provider Identifier 3: 051101973
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Other Provider Identifier State 3: AL
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Other Provider Identifier Issuer 3: BCBS NEW
Other Provider Identifier 4: L223
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4: AL
The first name of the provider, if the provider is an individual.
Other Provider Identifier Issuer 4: MEDICARE GROUP #
The middle name of the provider, if the provider is an individual.
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No