DR. SIMON FREYOU (NPI# 1336269976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336269976 |
| Entity Type | Individual |
| Full Name | DR. SIMON FREYOU |
| Credential | CRNP |
| Practice Address |
3455 Wilkens Ave Ste 301 Baltimore MD 21229-5214 |
| Practice Telephone | 6673093507 |
| Practice Fax Number | 6673093508 |
| Mailing Telephone | 6673093507 |
| Mailing Fax Number | 6673093508 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2019-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
R108647 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R108647 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | BCBS PROVIDER NUMBER | G8920007 | 01 |
| TRICARE | 262573538001 | 01 |
| Street Address |
3455 WILKENS AVE STE 301 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21229-5214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558969626 | Optimum Wellness Center LLC. | Community/Behavioral Health | 3455 Wilkens Ave Ste 301, Baltimore, MD 21229-5214 | 2020-10-12 |
| 1710585880 | Darryl Xavier Whitehead | Community/Behavioral Health | 3455 Wilkens Ave Ste 301, Baltimore, MD 21229-5214 | 2020-10-12 |
| 1932690716 | Ellen Joy Line | Social Worker | 3455 Wilkens Ave Ste 301, Baltimore, MD 21229-5214 | 2018-05-28 |
| 1487155776 | Freestate Behavioral Health Associates LLC | Social Worker | 3455 Wilkens Ave Ste 301, Baltimore, MD 21229-5214 | 2018-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265068373 | Bodyworks Medical | Clinic/Center | St. Agnes Medical Center, 3455 Wilkens Ave Suite 100, Baltimore, MD 21229 | 2020-03-20 |
| 1750932430 | Amanda Felix | Nurse Practitioner | 5411 Old Frederick Road, Catonsville, MD 21229 | 2019-09-24 |
| 1497317853 | Wakeelat A Adeoye | Nurse Practitioner | 5411 0ld Fredrick Rd, Suite 7, Baltimore, MD 21229 | 2019-07-05 |
| 1598328080 | Oprah Cherelle Keyes | Social Worker | 4511 Birchwood Drive, Baltimore, MD 21229 | 2019-04-19 |
| 1477051779 | Shahin Vohara | Dentist | Dental Dreams, 4510 Edmondson Avenue, Edmondson Village Shopping Center, Baltimore, MD 21229 | 2018-02-01 |
| 1386179299 | Sharon Mccollough | Counselor | 3219 Phelps Lane, First Floor, Baltimore, MD 21229 | 2017-04-28 |
| 1184175697 | Yekeen Odewale | Registered Nurse | 5411 Old Frederick Rd Ste 7, Baltimore, MD 21229 | 2016-10-19 |
| 1942608070 | Charity Ashe | Social Worker | 4024 Colborne Rd, Baltimore, MD 21229 | 2014-12-05 |
| 1376947127 | Sumanya Venkat Rao | Dentist | 4510 Edmondson Ave, Baltimore, MD 21229 | 2014-10-21 |
| 1497091573 | Anita Phillips | Social Worker | 5110 Frederick Avenue, Baltimore, MD 21229 | 2012-12-18 |
| Find all providers in zip 21229 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659981728 | Jamie Briddell | Nurse Practitioner | 250 N Calvert St, Baltimore, MD 21202-3505 | 2020-08-04 |
| 1790300903 | Hall Diabetes Management and Resource Center PC | Nurse Practitioner | 1900 E Northern Pkwy Ste T1, Baltimore, MD 21239-2120 | 2020-06-12 |
| 1356978530 | Melissa Irvin Sahm | Nurse Practitioner | 2634 Guilford Ave, Baltimore, MD 21218-4611 | 2020-03-26 |
| 1821646092 | Aaron Murfin | Nurse Practitioner | 1055 W Market St Ste H, Baltimore, OH 43105-1284 | 2019-08-29 |
| 1669024543 | Alpa Uchil | Nurse Practitioner | 601 N Caroline St Ste 5061, Baltimore, MD 21287-0006 | 2019-07-11 |
| 1982169918 | Stephanie Ann Wagner | Nurse Practitioner | 5601 Loch Raven Blvd Bldg Suite502, Baltimore, MD 21239-2945 | 2019-02-04 |
| 1386118289 | Dia Lynae Johnson | Nurse Practitioner | 4101 Glenhunt Rd, Baltimore, MD 21229-1705 | 2019-01-14 |
| 1083181077 | Gilah Speedone | Nurse Practitioner | 5915 Western Park Dr, Baltimore, MD 21209-3416 | 2018-10-27 |
| 1144719634 | Kathryn Ellen Menzel | Nurse Practitioner | 601 N Caroline St Fl 7, Baltimore, MD 21287-0006 | 2018-05-09 |
| 1659815520 | Leonard Mugo | Nurse Practitioner | 4611 Southwood Ave, Baltimore, MD 21206-2245 | 2016-12-13 |
| Find all providers in BALTIMORE | ||||
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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.