Janetta K Freeman, RNC, PAC
Individual provider Active NPI Surgical Physician Assistant · Ulysses, KS
NPI 1083700934 · NPPES record last updated Nov 9, 2020
Key facts
- NPI
- 1083700934
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 1500649 (KS)
- Practice address
- 505 N Main St
Ulysses, KS 67880-2135 - Phone
- (620) 356-1261
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of North Dakota School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pratt Regional Medical Center Corporation
Practice addresses (Care Compare)
124 Commodore St
Suite B
Pratt, KS 67124-2995
Phone (620) 672-6454
200 Commodore St
Pratt, KS 67124-2903
Phone (620) 672-7451
Hospital & facility affiliations
- Pratt Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080813000363 | KS | Practitioner - Physician Assistant | 9032284823 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1500649 | KS | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pratt Regional Medical Center Corporation | Current |
Accepting new patients | |
| Pratt Regional Medical Center Corporation | Current |
Accepting new patients | |
| Pratt Regional Medical Center Corporation | Current |
Accepting new patients | |
| Cancer Center of Kansas, P.a. | Past | Accepting new patients | |
| Commonspirit Kansas, Inc. | Past | Accepting new patients | |
| Commonspirit Kansas, Inc. | Past | Accepting new patients |
Locations
200 Commodore St
Pratt, KS 67124
Phone (620) 672-6476
124 Commodore St
Ste B
Pratt, KS 67124
Phone (620) 393-5661
Interoperability endpoints
- janetta.freeman.1@14930.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1500649 | KS | Yes |
Addresses
Primary practice location
505 N Main St
Ulysses, KS 67880-2135
Mailing address
505 N Main St
Ulysses, KS 67880-2135
Phone (620) 356-1261
Other practice location 1
200 Commodore St
Pratt, KS 67124-2903
Phone (620) 450-1130
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100340610B | Medicaid | KS |
Other providers in Ulysses, KS
- Dynatest Inc
- Family Dentistry
- Family Practice Associates of Ulysses LLC
- First Avenue Dental, P.a.
- Jacey Fischbach
- Good Choice Chiropractic,Inc
- Grant County Medical Equipment,LLC
- Chelsea Gray
- Rochelle Elieen Haney
- Brett Harrold
All providers in Ulysses, KS · Surgical Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.