Individual provider Active NPI

Kevin Lee Freebern, D.C.

  • Chiropractor
  • East Moline, IL
National Provider Identifier
1699758441
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038005378 Issued in IL
Practice address
918 16TH Ave
East Moline, IL 61244-2126
Phone
(309) 752-0750
Fax
(309) 752-0755
NPI assigned
Nov 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038005378 IL Primary

Addresses

Primary practice location

918 16TH Ave
East Moline, IL 61244-2126

Mailing address

918 16TH Ave
East Moline, IL 61244-2126
Phone (309) 752-0750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1699758441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 16TH AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612442126",
            "telephone_number": "309-752-0750",
            "fax_number": "309-752-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 16TH AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612442126",
            "telephone_number": "309-752-0750",
            "fax_number": "309-752-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEBERN",
        "first_name": "KEVIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038005378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.