NPIMap

Organization Active NPI

Freedom Mobile Phlebotomy

  • Clinical Medical Laboratory
  • Grayson, GA
National Provider Identifier
1649056250
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
FREEDOM MOBILE PHLEBOTOMY
Practice address
1790 Pinehurst View Dr
Grayson, GA 30017-7910
Phone
(404) 804-0741
NPI assigned
Sep 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Authorized official

Name
Shalaya Gray, MANPI 1851177406
Title
Phlebotomist Ceo
Phone
(404) 804-0741

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1790 Pinehurst View Dr
Grayson, GA 30017-7910

Mailing address

1790 Pinehurst View Dr
Grayson, GA 30017-7910
Phone (404) 804-0741

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1649056250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 PINEHURST VIEW DR",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177910",
            "telephone_number": "404-804-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 PINEHURST VIEW DR",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177910",
            "telephone_number": "404-804-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM MOBILE PHLEBOTOMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "SHALAYA",
        "authorized_official_title_or_position": "PHLEBOTOMIST CEO",
        "authorized_official_telephone_number": "404-804-0741",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.