Individual provider Active NPI

Dudley E. Freeman, M.D.

  • Obstetrics & Gynecology Physician
  • Amarillo, TX
National Provider Identifier
1821005372
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
K5529 Issued in TX
Practice address
7620 Wallace Blvd
Amarillo, TX 79124-2154
Phone
(806) 359-5468
Fax
(806) 358-1162
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X K5529 TX Primary

Addresses

Primary practice location

7620 Wallace Blvd
Amarillo, TX 79124-2154

Mailing address

7620 Wallace Blvd
Amarillo, TX 79124-2154
Phone (806) 359-5468

Other identifiers 1

IdentifierTypeStateIssuer
140997106MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120522001261 TX Practitioner - Obstetrics/Gynecology 1456357946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Tulane University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Panhandle Obstetrics and GynecologyGroup PAC ID 7810993391, 8 clinicians

Practice addresses (Care Compare)

7620 Wallace Blvd
Amarillo, TX 79124-2154
Phone (806) 359-5468

Hospital & facility affiliations

  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Panhandle Obstetrics & Gynecology Obstetrics & Gynecology CurrentSince Feb 29, 2012 Accepting new patients
Bsa Hospital LLC Past Accepting new patients
Northwest Texas Healthcare System Inc Past Accepting new patients
Harrington Physicians, Inc. Past Accepting new patients

Locations

3501 S Soncy Rd
Ste 140
Amarillo, TX 79119
Phone (806) 355-5625

7620 Wallace Blvd
Amarillo, TX 79124
Phone (806) 359-5468

Organizations & group practices 4

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1821005372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791242154",
            "telephone_number": "806-359-5468",
            "fax_number": "806-358-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791242154",
            "telephone_number": "806-359-5468",
            "fax_number": "806-358-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "DUDLEY",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "K5529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140997106",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.