Active NPI
Charisma Freeman, NP-C
- Nurse Practitioner
- Douglasville, GA
National Provider Identifier
1417324484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN184104
- Practice address
- 6025 Professional Pkwy
Suite 200
Douglasville, GA 30134-5609 - Phone
- (678) 504-7362
- Fax
- (678) 244-3449
- NPI assigned
- Aug 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN184104 | GA | Primary |
Addresses
Primary practice location
6025 Professional Pkwy
Suite 200
Douglasville, GA 30134-5609
Mailing address
6025 Professional Pkwy
Suite 200
Douglasville, GA 30134-5609
Phone (678) 504-7362
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN184104 | GA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440547200000",
"number": "1417324484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6025 PROFESSIONAL PKWY",
"address_2": "SUITE 200",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301345609",
"telephone_number": "678-504-7362",
"fax_number": "678-244-3449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6025 PROFESSIONAL PKWY",
"address_2": "SUITE 200",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301345609",
"telephone_number": "678-504-7362",
"fax_number": "678-244-3449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "CHARISMA",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-26",
"last_updated": "2015-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN184104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.