Individual provider Active NPI

Gary Austin Freeman

  • Pharmacist
  • Lithonia, GA
National Provider Identifier
1225631153
Registry record updated Nov 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH031993 Issued in GA
Practice address
5401 Fairington Rd
Lithonia, GA 30038-5113
Phone
(770) 593-4998
NPI assigned
Nov 22, 2020
Last updated
Nov 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH031993 GA Primary

Addresses

Primary practice location

5401 Fairington Rd
Lithonia, GA 30038-5113

Mailing address

5401 Fairington Rd
Lithonia, GA 30038-5113

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 770-593-4998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RPH031993GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1225631153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 FAIRINGTON RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300385113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 FAIRINGTON RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300385113",
            "telephone_number": "770-593-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "GARY",
        "middle_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-22",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH031993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "770-593-4998",
            "affiliation": "N",
            "address_1": "5401 Fairington Rd",
            "city": "Lithonia",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300385113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.