Individual provider Active NPI

Holly K. Freeman, CRNP

  • Nurse Practitioner
  • Tuscaloosa, AL
National Provider Identifier
1023106176
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-060328 Issued in AL
Practice address
100 Towncenter Blvd
Ste 300
Tuscaloosa, AL 35406-1835
Phone
(205) 710-3838
Fax
(205) 710-3839
NPI assigned
Oct 11, 2006
Last updated
Oct 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-060328 AL Primary

Addresses

Primary practice location

100 Towncenter Blvd
Ste 300
Tuscaloosa, AL 35406-1835

Mailing address

100 Towncenter Blvd
Ste 300
Tuscaloosa, AL 35406-1835
Phone (205) 710-3838

Other identifiers 1

IdentifierTypeStateIssuer
1-060328OtherALLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050412000543 AL Practitioner - Nurse Practitioner 9739126764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of Tuscaloosa, P.C. CurrentSince Mar 27, 2022 Accepting new patients

Locations

100 Rice Mine Rd N
Ste 100
Tuscaloosa, AL 35406
Phone (205) 349-4200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1023106176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TOWNCENTER BLVD",
            "address_2": "STE 300",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354061835",
            "telephone_number": "205-710-3838",
            "fax_number": "205-710-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TOWNCENTER BLVD",
            "address_2": "STE 300",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354061835",
            "telephone_number": "205-710-3838",
            "fax_number": "205-710-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "HOLLY",
        "middle_name": "K.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-060328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1-060328",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.