NPIMap

Organization Active NPI

Freedom Psychiatry Services PLLC

  • Child & Adolescent Psychiatry Physician
  • Raleigh, NC
National Provider Identifier
1699279448
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
FREEDOM PSYCHIATRY SERVICES PLLC
Practice address
7540 Ramble Way Ste 109
Raleigh, NC 27616-4318
Phone
(919) 457-1200
Fax
(919) 457-1100
NPI assigned
Mar 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Kondal Madaram, MDNPI 1003952144
Title
President
Phone
(919) 271-6784

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
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

7540 Ramble Way Ste 109
Raleigh, NC 27616-4318

Mailing address

7540 Ramble Way Ste 109
Raleigh, NC 27616-4318
Phone (919) 457-1100

Other practice location 1

301 Pinner Weald Way
Cary, NC 27513-2618
Phone (919) 271-6784

Other identifiers 1

IdentifierTypeStateIssuer
2015-01900OtherNCNORTH CAROLINA MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190517001339 NC Part B Supplier - Clinic/Group Practice 9931442704 Receives reassigned benefits from 4 practitioners
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

301 Pinner Weald Way
Ste 202
Cary, NC 27513
Phone (919) 802-1417

301 Pinner Weald Way
Cary, NC 27513
Phone (919) 271-6784

2231 Nash St NW
Wilson, NC 27896
Phone (252) 320-0544

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1699279448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 RAMBLE WAY STE 109",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276164318",
            "telephone_number": "919-457-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 RAMBLE WAY STE 109",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276164318",
            "telephone_number": "919-457-1200",
            "fax_number": "919-457-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Pinner Weald Way",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275132618",
            "country_code": "US",
            "telephone_number": "919-271-6784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FREEDOM PSYCHIATRY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "MADARAM",
        "authorized_official_first_name": "KONDAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-271-6784",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA MEDICAL BOARD",
            "identifier": "2015-01900",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.