NPIMap

Individual provider Active NPI

Zachary Turley Freestone, D.O.

  • Nephrology Physician
  • American Fork, UT
National Provider Identifier
1790070449
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
8937070-1204 Issued in UT
Practice address
1175 E 50 S Ste 161
American Fork, UT 84003-2845
Phone
(801) 377-4623
Fax
(801) 377-6832
NPI assigned
Jun 10, 2011
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X SL0819 NV
Nephrology Physician 207RN0300X 8937070-1204 UT Primary

Addresses

Primary practice location

1175 E 50 S Ste 161
American Fork, UT 84003-2845

Mailing address

1055 N 500 W
Attn: Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Revere Health PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20160815002675 UT Practitioner - Nephrology 6103058714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

1055 N 500
Provo, UT 84604-3305
Phone (801) 429-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
SL0819NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Aug 1, 2016 Accepting new patients
Revere Health PC CurrentSince Aug 1, 2016 Accepting new patients

Locations

1175 E 50 S
Ste 161
American Fork, UT 84003
Phone (801) 377-4623

1175 E 50 S
Ste 251
American Fork, UT 84003
Phone (801) 492-2815

2183 W Main St
Ste A107
Lehi, UT 84043
Phone (385) 203-1215

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1000 N Main St
Ste C
Richfield, UT 84701
Phone (435) 238-7000

Interoperability endpoints

  • Direct secure messaging: zacharyfreestone@cuccu.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1790070449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E 50 S STE 161",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032845",
            "telephone_number": "801-377-4623",
            "fax_number": "801-377-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREESTONE",
        "first_name": "ZACHARY",
        "middle_name": "TURLEY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2023-11-27",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "SL0819",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "UT",
            "license": "8937070-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "1175 E 50 S Ste 161",
            "city": "American Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840032845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.