Individual provider Active NPI

Kimberly Sue Freese-Beal, MD

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1275560773
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301082465 Issued in MI
Practice address
400 Hinckley Blvd
Suite 100
Jackson, MI 49203-6125
Phone
(517) 784-0141
Fax
(517) 787-3462
NPI assigned
Jun 28, 2006
Last updated
Feb 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301082465 MI Primary

Addresses

Primary practice location

400 Hinckley Blvd
Suite 100
Jackson, MI 49203-6125

Mailing address

PO Box 67000
Department 272801
Detroit, MI 48267-2728
Phone (517) 784-0141

Other names 1

  • Kimberly Sue Fresse Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kfreese3@hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060808000509 MI Practitioner - Family Practice 2466455688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

400 Hinckley Blvd
Suite 100
Jackson, MI 49203-6152
Phone (517) 205-8991

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital CurrentSince Jul 1, 2007 Accepting new patients
W. a. Foote Memorial Hospital Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
W.a. Foote Memorial Hospital Family Medicine CurrentSince Jul 1, 2007 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

27931 C Dr N
Albion, MI 49224
Phone (517) 629-8311

1401 W North St
Jackson, MI 49202
Phone (517) 205-2555

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

400 Hinckley Blvd
Jackson, MI 49203
Phone (517) 205-2299

400 Hinckley Blvd
Ste 100
Jackson, MI 49203
Phone (517) 205-8991

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

Interoperability endpoints

  • Direct secure messaging: kfreesebeal456354@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1275560773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPARTMENT 272801",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672728",
            "telephone_number": "517-784-0141",
            "fax_number": "517-787-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HINCKLEY BLVD",
            "address_2": "SUITE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492036125",
            "telephone_number": "517-784-0141",
            "fax_number": "517-787-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREESE-BEAL",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301082465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfreese3@hfhs.org",
            "affiliation": "N",
            "address_1": "400 Hinckley Blvd",
            "address_2": "Suite 100",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492036125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "FRESSE",
            "middle_name": "SUE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.