Freedom Park Medical Services a Medical Corporation

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

FREEDOM PARK MEDICAL SERVICES A MEDICAL CORPORATION

Practice address

1081 N China Lake Blvd
Ridgecrest, CA 93555-3130

Phone

(469) 401-2386

NPI assigned

Jun 7, 2018

Organization subpart

No

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

Authorized official

Name

Kathleen Kondas

Title

VP Provider Enrollment

Phone

(973) 251-1132

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1679066476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891939085",
            "telephone_number": "954-838-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 N CHINA LAKE BLVD",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553130",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM PARK MEDICAL SERVICES A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "VP PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "973-251-1132"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Ridgecrest, CA
• Providers in Ridgecrest, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.