Kalliope Johanna Freburg, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9111233 Issued in FL

Practice address

2404 US Highway 19
Holiday, FL 34691-3943

Phone

(727) 945-0100

NPI assigned

May 5, 2018

Last updated

Nov 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25054/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doctors Urgent Care LLC

  • Urgent Care Clinic/Center
  • Holiday, FL
  • NPI 1346414919
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1013406073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 US HIGHWAY 19",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346913943",
            "telephone_number": "727-945-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 US HIGHWAY 19",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346913943",
            "telephone_number": "727-945-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34621 US Highway 19 N",
            "address_purpose": "LOCATION",
            "city": "Palm Harbor",
            "state": "FL",
            "postal_code": "346842152",
            "country_code": "US",
            "telephone_number": "727-953-9888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13256 SR 54",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "FL",
            "postal_code": "335563483",
            "country_code": "US",
            "telephone_number": "813-920-0023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREBURG",
        "first_name": "KALLIOPE",
        "middle_name": "JOHANNA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-05",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9111233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Primary Care LLC
• Charles Joseph Flynn Jr., PTA
• Rhonda Suzette Fogle
• Laurie J Folkman, MD
• Folmed
• Anneris Garcia Fundora
• Adilen Garcia
• Svetlana Gendelman
• Raafat Gergis, RPH
• Dimitris Gerothanassis, M.D.

• Medical Physician Assistant in Holiday, FL
• Providers in Holiday, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.