DR. KEVIN LEE FREEMAN (NPI# 1821008608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821008608 |
| Entity Type | Individual |
| Full Name | DR. KEVIN LEE FREEMAN |
| Credential | PHARMD,BCNSP |
| Practice Address |
1030 Jefferson Ave Memphis TN 38104-2127 |
| Mailing Address |
219 Home Pl Collierville TN 38017-1482 |
| Practice Telephone | 9015238990 |
| Practice Fax Number | 9015777306 |
| Mailing Telephone | 9015238990 |
| Mailing Fax Number | 9015777306 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1835N1003X |
Pharmacist Specialization: Nutrition Support |
10917 | TN | Pharmacy Service Providers |
| X | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
10917 | TN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689741993 | Kevin Andrew Freeman | Counselor | 200 Westpark Dr, Suite 325, Peachtree City, GA 30269-3534 | 2006-11-29 |
| 1649370776 | Kevin Wayne Freeman | Registered Nurse | 4500 E Speedway Blvd, Suite 60, Tucson, AZ 85712-5303 | 2006-09-25 |
| 1295230050 | Kevin M Freeman | Social Worker | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2018-03-26 |
| 1932328457 | Kevin M Freeman | Dentist | 4660 Beechnut St, Suite 228, Houston, TX 77096-1824 | 2007-04-24 |
| 1427069806 | Kevin Stewart Freeman | Specialist | 33 Upper Riverdale Rd Sw, Suite 114, Riverdale, GA 30274-2626 | 2006-08-10 |
| 1962434092 | Kevin Freeman | Pediatrics | 5727 Prosperity Crossing Dr, Ste 1500, Charlotte, NC 28269-2206 | 2006-07-07 |
| Street Address |
1030 JEFFERSON AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982697025 | Katherine Denton Sanford | Optometrist | 1030 Jefferson Ave, Mail Code 112d, Memphis, TN 38104-2127 | 2005-08-24 |
| 1528667938 | Mckenzie Bahl | Recreation Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-19 |
| 1427656834 | Phillip David Resuggan | Music Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2193 | 2020-10-16 |
| 1962009159 | Rachel Diann Roberts | Nurse Anesthetist, Certified Registered | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-01 |
| 1225643018 | Melanie Warren | Nurse Practitioner | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-09-09 |
| 1942828892 | Brady Cole | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-08 |
| 1457978595 | Mariko Thel | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-05 |
| 1215554910 | Weston Paul Keen | Pharmacy | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-29 |
| 1225655236 | Rebecca Fong | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-26 |
| 1225653660 | Brandy Hollums | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 1835N1003X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Nutrition Support |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427170232 | Henry Larkin Wright | Pharmacist | 5214 Village Crest Way, Apt. 125, Knoxville, TN 37924-5005 | 2007-04-04 |
| 1285255687 | Shannon Slate | Pharmacist | 217 W Maplewood Ln, Nashville, TN 37207-2981 | 2020-04-27 |
| 1407317563 | Andrea Mcnalley Gerwin | Pharmacist | 975 E 3rd St, Chattanooga, TN 37403-2147 | 2019-03-29 |
| 1225442155 | Bradley Provence | Pharmacist | 7899 C St, Millington, TN 38053-2137 | 2014-06-18 |
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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.