Individual provider Active NPI

Allan Freedman, M.D.

  • Hematology & Oncology Physician
  • Snellville, GA
National Provider Identifier
1811086457
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
21690 Issued in GA
Practice address
1700 Tree LN
Suite 490
Snellville, GA 30078-6782
Phone
(770) 979-2828
Fax
(770) 979-3139
NPI assigned
Oct 12, 2006
Last updated
Jan 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 21690 GA Primary

Addresses

Primary practice location

1700 Tree LN
Suite 490
Snellville, GA 30078-6782

Mailing address

6127 Kings Mountain CT
Stone Mountain, GA 30087-1920
Phone (770) 979-2828

Other identifiers 3

IdentifierTypeStateIssuer
00245495JMedicaidGA
1508926759OtherGAGROUP NPI NUMBER
1811086457OtherGAPROVIDER NPI NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080211000484 GA Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 7517040769 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21690GAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Pathology Assoc PC Current Accepting new patients
Suburban Hematology Oncology Associates, PC Hematology & Oncology CurrentSince Jan 1, 2010 Accepting new patients
Gwinnett Medical Group, Inc Current Accepting new patients
Northside Hospital, Inc. CurrentSince Jul 1, 2012 Accepting new patients
North Atlanta Oncology Services LLC CurrentSince Jul 1, 2019 Accepting new patients
Northside Hospital, Inc. Current Accepting new patients

Locations

2098 Teron Trce
Ste 400
Dacula, GA 30019
Phone (678) 312-6800

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

600 Professional Dr
Ste 210
Lawrenceville, GA 30046
Phone (770) 963-8030

631 Professional Dr
Ste 450
Lawrenceville, GA 30046
Phone (770) 963-8030

1700 Tree Ln
Ste 490
Snellville, GA 30078
Phone (770) 963-4445

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1811086457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6127 KINGS MOUNTAIN CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871920",
            "telephone_number": "770-979-2828",
            "fax_number": "770-979-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TREE LN",
            "address_2": "SUITE 490",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786782",
            "telephone_number": "770-979-2828",
            "fax_number": "770-979-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDMAN",
        "first_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "21690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00245495J",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1508926759",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI NUMBER",
            "identifier": "1811086457",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.