Freestate Health PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

04-33447 Issued in KS

Legal business name

FREESTATE HEALTH PLLC

Practice address

4723 E Douglas Ave
Wichita, KS 67218-1012

Phone

(888) 505-1776

Fax

(888) 505-1776

NPI assigned

Apr 18, 2017

Organization subpart

No

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

Authorized official

Name

Elisha Yaghmai, MD, MPH&TM

Title

President

Phone

(888) 505-1776

Specialties & licenses 3

Addresses

Other names 1

• FreeState Doing business as

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1013441930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4723 E DOUGLAS AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181012",
            "telephone_number": "888-505-1776",
            "fax_number": "888-505-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4723 E DOUGLAS AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181012",
            "telephone_number": "888-505-1776",
            "fax_number": "888-505-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREESTATE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "YAGHMAI",
        "authorized_official_first_name": "ELISHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-505-1776",
        "authorized_official_credential": "MD, MPH&TM"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-33447",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-33447",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "KS",
            "license": "04-33447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FreeState",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Freedom Path Counseling, LLC
• April N Freeman
• Branson Michael Freeman, LMSW
• Christopher Todd Freeman
• Claire Freeman
• Amber N Freeze-Carter, LCMFT
• Alice Maria Freire Fidelis, MD
• Theodore Fremont
• Benjamin French
• Cecily French, OTA

• Multi-Specialty Clinic/Center in Wichita, KS
• Providers in Wichita, KS by specialty
• Multi-Specialty Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.