Individual provider Active NPI

Jessica McLellan Freeman, PA

  • Medical Physician Assistant
  • Hoover, AL
National Provider Identifier
1750304994
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 438 Issued in AL
Practice address
4517 Southlake Pkwy
Hoover, AL 35244-3280
Phone
(205) 985-4111
Fax
(205) 985-4326
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 438 AL Primary

Addresses

Primary practice location

4517 Southlake Pkwy
Hoover, AL 35244-3280

Mailing address

4517 Southlake Pkwy
Hoover, AL 35244-3280
Phone (205) 985-4111

Other identifiers 1

IdentifierTypeStateIssuer
009935048MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000359 AL Practitioner - Physician Assistant 2365461720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

831 Hillcrest Rd
Mobile, AL 36695-4074
Phone (251) 435-2663

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 438ALMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Orthopaedic Alliance PLLC CurrentSince Sep 1, 2023 Accepting new patients
Southern Orthopaedic Alliance, PLLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

3686 Grandview Pkwy
Ste 430
Birmingham, AL 35243
Phone (205) 605-8180

4517 Southlake Pkwy
Hoover, AL 35244
Phone (205) 329-7585

831 Hillcrest Rd
Mobile, AL 36695
Phone (251) 633-4949

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1750304994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 SOUTHLAKE PKWY",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443280",
            "telephone_number": "205-985-4111",
            "fax_number": "205-985-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4517 SOUTHLAKE PKWY",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443280",
            "telephone_number": "205-985-4111",
            "fax_number": "205-985-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "JESSICA",
        "middle_name": "MCLELLAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA 438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009935048",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

Verify at the official NPI Registry.