Individual provider Active NPI

Clyde Freeman III, M.D.

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1609035948
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD037329 Issued in DC
Practice address
700 2ND St NE
Washington, DC 20002-8100
Phone
(202) 346-3000
Fax
(202) 346-3402
NPI assigned
Jun 2, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD037329 DC Primary

Addresses

Primary practice location

700 2ND St NE
Washington, DC 20002-8100

Mailing address

10616 Harper Ave
Silver Spring, MD 20901-1413
Phone (202) 731-0567

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081029000217 DC Practitioner - Internal Medicine 8527126960 Reassigns benefits to 1 organization
I20150423000358 MD Practitioner - Internal Medicine 8527126960 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD037329DCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Howard University Internal Medicine CurrentSince Feb 1, 2015 Accepting new patients
Mdics at Calvert LLC CurrentSince May 15, 2016 Accepting new patients

Locations

2041 Georgia Ave NW
Washington, DC 20060
Phone (202) 865-3785

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

2101 Medical Park Dr
Ste 305
Silver Spring, MD 20902
Phone (301) 754-0833

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1609035948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10616 HARPER AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011413",
            "telephone_number": "202-731-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 2ND ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200028100",
            "telephone_number": "202-346-3000",
            "fax_number": "202-346-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "CLYDE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-02",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD037329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 2nd St NE",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200028100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.