Kenton C. Freeman, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

104065 Issued in MO

Practice address

218 S Woodbine Rd
Saint Joseph, MO 64506-3447

Phone

(816) 383-3680

NPI assigned

Nov 7, 2005

Last updated

Mar 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Precision Spine & Orthopaedic Specialists, LLC

  dba Precision Spine

  • Orthopaedic Surgery Physician
  • Overland Park, KS
  • NPI 1508113622
  NPD
• Clark Family Dentistry

  dba Heather E. Clark

  • General Practice Dentistry
  • Saint Joseph, MO
  • NPI 1053568477
  NPD (past)
• SSM Regional Health Services

  dba SSM Health Pharmacy

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1922119726
  NPD (past)
• St. Joseph Family Medical Clinic, Inc.

  • Specialist
  • Saint Joseph, MO
  • NPI 1700858180
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1043291297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 RED OAK CT",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645064936",
            "telephone_number": "816-233-0211",
            "fax_number": "816-233-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 S WOODBINE RD",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063447",
            "telephone_number": "816-383-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "KENTON",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "104065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208721506",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF KC",
            "identifier": "24719017",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE #",
            "identifier": "250008744",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROV #",
            "identifier": "0008108",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "G50233",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Foundation Recovery Center
• Jody Franken
• Scott Alan Franksen, DO
• Fred E. Potts IV, M.D.
• Fred E. Potts, IV, MD, LLC (Covenant Primary Care)
• Steven P Freeman, D.O.
• Freudenthal Home Health, LLC (Freudenthal Hospice)
• Freudenthal Home Health, LLC (Freudenthal Home Health)
• Freudenthal Primary Care for Seniors, LLC (Freudenthal Primary Care at Home)
• Amanda Beth Friesz, AANP

• Physical Medicine & Rehabilitation Physician in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Physical Medicine & Rehabilitation Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.