Individual provider Active NPI

Blake Freed, DC

  • Chiropractor
  • Ewa Beach, HI
National Provider Identifier
1750099545
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-1548-0 Issued in HI
Practice address
91-1123 Keanui Drive #228
Ewa Beach, HI 96706
Phone
(808) 321-0253
NPI assigned
Nov 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-1548-0 HI Primary

Addresses

Primary practice location

91-1123 Keanui Drive #228
Ewa Beach, HI 96706

Mailing address

91-1123 Keanui Drive #228
Ewa Beach, HI 96706
Phone (808) 321-0253

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DC-1548-0HIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Community Chiropractic Inc Chiropractor PastSince Nov 13, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1750099545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1123 KEANUI DRIVE #228",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "96706",
            "telephone_number": "808-321-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1123 KEANUI DRIVE #228",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "96706",
            "telephone_number": "808-321-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREED",
        "first_name": "BLAKE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "DC-1548-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.