Individual provider Active NPI

Pamela Deanne Freeman, CRNA

  • Certified Registered Nurse Anesthetist
  • Gainesville, FL
National Provider Identifier
1417187212
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11001723 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-2321
Phone
(352) 273-8610
Fax
(781) 407-0998
NPI assigned
Jul 15, 2009
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2257945 MA
Certified Registered Nurse Anesthetist 367500000X APRN11001723 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-2321

Mailing address

PO Box 100254
Gainesville, FL 32610-0254
Phone (352) 273-8610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091105000452 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709924178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pratt Anesthesiology Associates IncGroup PAC ID 0547151151, 153 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-6044

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2257945MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Anesthesiology Associates, Inc CurrentSince May 1, 2022 Accepting new patients
Advanced Gastroenterology Health Care Centers CurrentSince Sep 1, 2000 Accepting new patients

Locations

315 Palm Coast Pkwy NE
Ste 5
Palm Coast, FL 32137
Phone (386) 763-4920

1690 Dunlawton Ave
Ste 210
Port Orange, FL 32127
Phone (386) 763-4920

1690 Dunlawton Ave
Ste 230
Port Orange, FL 32127
Phone (386) 763-4920

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

Organizations & group practices 2

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 1

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1417187212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100254",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100254",
            "telephone_number": "352-273-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326102321",
            "telephone_number": "352-273-8610",
            "fax_number": "781-407-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "PAMELA",
        "middle_name": "DEANNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "2257945",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11001723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.