Individual provider Active NPI

Leonard F Freeman III, BS

  • Pharmacist
  • Atlanta, GA
National Provider Identifier
1770181588
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
015734 Issued in GA
Practice address
2175 Parklake Dr NE
Atlanta, GA 30345-2845
Phone
(770) 496-7400
NPI assigned
Oct 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 015734 GA Primary

Addresses

Primary practice location

2175 Parklake Dr NE
Atlanta, GA 30345-2845

Mailing address

146 Redfern Dr
Saint Simons Island, GA 31522-2042

Other identifiers 1

IdentifierTypeStateIssuer
053190374OtherGASTATE DRIVERS LICENSE

Other names 1

  • Trey Freeman Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL trey.freeman@kroger.com Direct

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
015734GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1770181588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 REDFERN DR",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 PARKLAKE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452845",
            "telephone_number": "770-496-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "LEONARD",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "015734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DRIVERS LICENSE",
            "identifier": "053190374",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "trey.freeman@kroger.com",
            "affiliation": "N",
            "endpointDescription": "company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "company email",
            "address_1": "2175 Parklake Dr NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303452845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TREY",
            "last_name": "FREEMAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.