NPIMap

Individual provider Active NPI

Nicole Ryba Freeman, NP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1720687593
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5013681 Issued in NC
Practice address
6324 Fairview Rd Ste 400
Charlotte, NC 28210-4278
Phone
(980) 302-8626
Fax
(980) 302-8639
NPI assigned
Oct 22, 2020
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5013681 NC Primary

Addresses

Primary practice location

6324 Fairview Rd Ste 400
Charlotte, NC 28210-4278

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (980) 302-8626

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nfreeman854819@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201231000519 NC Practitioner - Nurse Practitioner 8022421593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

6324 Fairview Rd
Suite 400
Charlotte, NC 28210-4278
Phone (980) 302-8642

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5013681NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital CurrentSince Apr 24, 2023 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 22, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 22, 2022 Accepting new patients
The Presbyterian Hospital CurrentSince Apr 24, 2023 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-2670

6324 Fairview Rd
Ste 400
Charlotte, NC 28210
Phone (980) 302-8626

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: nfreeman854819@direct.novanthealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1720687593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "980-302-8626",
            "fax_number": "980-302-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104278",
            "telephone_number": "980-302-8626",
            "fax_number": "980-302-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "NICOLE",
        "middle_name": "RYBA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nfreeman854819@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "6324 Fairview Rd Ste 400",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282104278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.