Freeman Tichatonga Changamire, M.D., SC.D., MBA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

50191 Issued in KY

Practice address

7926 Preston Hwy Ste 106
Louisville, KY 40219-3848

Phone

(502) 964-4357

Fax

(502) 966-5948

NPI assigned

Jul 9, 2007

Last updated

Dec 26, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: fchangamire136538@direct.nortonhealthcare.org
• Direct secure messaging: fchangamire40016@direct.southcoast.org

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.

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  NPD

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

{
    "created_epoch": "1183939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1639377963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7926 PRESTON HWY STE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402193848",
            "telephone_number": "502-964-4357",
            "fax_number": "502-966-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANGAMIRE",
        "first_name": "FREEMAN",
        "middle_name": "TICHATONGA",
        "credential": "M.D., SC.D., MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-09",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "244111",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "38679",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "50191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-KY",
            "identifier": "000001121829",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "386790",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "234001",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K231120",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110086725/A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Chaney
• Barbara Karen Chang-Wai-Ling, M.D.
• Bruce Shoo Tang Chang, MD
• Jea Hoon Chang, DMD
• Maggie Yanting Chang, MD
• David G Changaris, MD
• Ju H Chao, D.O.
• Brittany Andriot Chapman, MD
• Callie Chapman
• David Ryan Chapman

• Family Medicine Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.