Individual provider Active NPI

Kara Jordan Freeman, PA-C

  • Physician Assistant
  • Terre Haute, IN
National Provider Identifier
1194347765
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003131A Issued in IN
Practice address
830 S 6TH St
Terre Haute, IN 47807-4712
Phone
(812) 213-8080
NPI assigned
May 17, 2020
Last updated
Oct 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 10003131A IN Primary

Addresses

Primary practice location

830 S 6TH St
Terre Haute, IN 47807-4712

Mailing address

7911 Michigan Rd
Indianapolis, IN 46268-1915
Phone (901) 283-0956

Other practice location 1

300 W Oak St
Carbondale, IL 62901-1400
Phone (618) 453-8850

Other practice location 2

500 Saluki Blvd Apt 1024A
Carbondale, IL 62903-8303
Phone (901) 283-0956

Other practice location 3

7911 Michigan Rd
Indianapolis, IN 46268-1915
Phone (317) 956-6288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20201125001187 IN Practitioner - Physician Assistant 6608287594 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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": "1589673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1194347765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7911 MICHIGAN RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681915",
            "telephone_number": "901-283-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S 6TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478074712",
            "telephone_number": "812-213-8080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011400",
            "country_code": "US",
            "telephone_number": "618-453-8850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Saluki Blvd Apt 1024A",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629038303",
            "country_code": "US",
            "telephone_number": "901-283-0956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7911 Michigan Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462681915",
            "country_code": "US",
            "telephone_number": "317-956-6288",
            "fax_number": "317-956-6289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "KARA",
        "middle_name": "JORDAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-17",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003131A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.