Freedom Pathology LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

FREEDOM PATHOLOGY LLC

Practice address

4849 Paulsen St Ste 212
Savannah, GA 31405-4425

Phone

(912) 239-4235

NPI assigned

Oct 17, 2022

Last updated

Oct 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Todd Bruker, MDNPI 1376500835

Title

Owner

Phone

(912) 239-4235

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Todd Bruker, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Savannah, GA
  • NPI 1376500835
  NPD Authorized official

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1447976022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16266",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314162966",
            "telephone_number": "912-239-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 PAULSEN ST STE 212",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054425",
            "telephone_number": "912-239-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM PATHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-16",
        "status": "A",
        "authorized_official_last_name": "BRUKER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-239-4235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Whitley L Frazier, LCSW
• Frederic C. Spector DPM PC
• Frederick Reconstructive Services LLC
• Freedom Mobility Center, Inc.
• Ashley Freeman
• Caroline Kaufman Freeman, OD
• Carson Freeman
• Casey Tuttle Freeman, CRNA
• Cornelius Edward Freeman, MD

• Clinical Medical Laboratory in Savannah, GA
• Providers in Savannah, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.