Individual provider Active NPI

Kimberly Dawn Freitas, MSN, RNC-MNN, IBCLC

  • Family Nurse Practitioner
  • Lynchburg, VA
National Provider Identifier
1790277663
Registry record updated Sep 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024179612 Issued in VA
Practice address
3300 Rivermont Ave
Lynchburg, VA 24503-2030
Phone
(434) 200-3000
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001223303 VA
Lactation Consultant (Registered Nurse) 163WL0100X L-108348 VA
Family Nurse Practitioner 363LF0000X 0024179612 VA Primary

Addresses

Primary practice location

3300 Rivermont Ave
Lynchburg, VA 24503-2030

Mailing address

3300 Rivermont Ave
Lynchburg, VA 24503-2030
Phone (434) 401-9344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20210104000031 VA Practitioner - Nurse Practitioner 2961815352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Health Services of Central Virginia IncGroup PAC ID 6901907120, 25 clinicians

Practice addresses (Care Compare)

114 Nationwide Dr
Lynchburg, VA 24502-4271
Phone (434) 237-7890

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0001223303VAMDRegistered Nurse
L-108348VAMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Health Services of Central Virginia, Inc. CurrentSince Sep 1, 2020 Accepting new patients

Locations

114 Nationwide Dr
Lynchburg, VA 24502
Phone (434) 237-7890

3300 Rivermont Ave
Lynchburg, VA 24503
Phone (434) 200-4668

Interoperability endpoints

  • Direct secure messaging: women'shealthservicesofcentralva.kimberlyfreitas@146509.advancedmd-direct.com

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.

Hospital & facility affiliations 7

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599350400000",
    "number": "1790277663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 RIVERMONT AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245032030",
            "telephone_number": "434-401-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 RIVERMONT AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245032030",
            "telephone_number": "434-200-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREITAS",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "MSN, RNC-MNN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2020-09-06",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001223303",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VA",
            "license": "L-108348",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024179612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.