FREEDOM MEDICAL CARE, PLLC (NPI# 1457972747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457972747 |
| Entity Type | Organization |
| Organization Name | FREEDOM MEDICAL CARE, PLLC |
| Practice Address |
4008 Maccorkle Ave Sw South Charleston WV 25309-1510 |
| Practice Telephone | 6812052570 |
| Practice Fax Number | 8558824492 |
| Mailing Telephone | 6812052570 |
| Mailing Fax Number | 8558824492 |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2020-04-28 |
| Authorized Official Name | ZACHARY HOLBERT (FNP) |
| Authorized Official Telephone | 3044007241 |
| Authorized Official Credential | FNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4008 MACCORKLE AVE SW |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144350075 | To Healthy Eyes | Optometrist | 4008 Maccorkle Ave Sw, South Charleston, WV 25309-1510 | 2007-03-07 |
| 1124234836 | To Healthy Eyes | Eyewear Supplier (Equipment, not the service) | 4008 Maccorkle Ave Sw, South Charleston, WV 25309-1510 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1417206988 | Chera Irene Brumfield | Nurse Practitioner | 2930 Macon St, South Charleston, WV 25303-1626 | 2012-08-30 |
| 1982687992 | Janet S. Bennett | Nurse Practitioner | 434 Division Street, South Charleston, WV 25309-1433 | 2005-11-23 |
| 1336751130 | Mary Beth Moore Miller | Nurse Practitioner | 332 6th Ave, South Charleston, WV 25303-1246 | 2020-08-21 |
| 1609494269 | Tabitha Michelle Spence | Nurse Practitioner | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 | 2020-07-10 |
| 1962028738 | Heath Collin Barnette | Nurse Practitioner | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2020-06-17 |
| 1629690037 | Stephanie Shamma | Nurse Practitioner | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1398 | 2020-05-08 |
| 1891339586 | Tarrin Layne | Nurse Practitioner | 4610 Kanawha Ave Sw Ste 402, South Charleston, WV 25309-1367 | 2019-11-05 |
| 1114573417 | Kelsey Strickland | Nurse Practitioner | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2019-08-13 |
| 1558845222 | Kara Gray | Nurse Practitioner | 4607 Maccorkle Ave Sw Ste 406, South Charleston, WV 25309-1364 | 2018-09-19 |
| Find all providers in SOUTH CHARLESTON | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
Please comment or provide details below to improve the information on FREEDOM MEDICAL CARE, PLLC.
| 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.