Kellie Freeborn, NP

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

NPF12491 Issued in CA

Practice address

5555 Grossmont Center Drive
La Mesa, CA 91942-3019

Phone

(619) 644-4401

NPI assigned

Jul 4, 2006

Last updated

Dec 15, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kellie Freeborn Duffield Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Grossmont Emergency Medical Group

  • Emergency Medicine Physician
  • La Mesa, CA
  • NPI 1861437501
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1841220860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12170",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852170",
            "telephone_number": "877-818-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DRIVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-644-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEBORN",
        "first_name": "KELLIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "NPF12491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN581933",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "FREEBORN DUFFIELD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Franklin Kalmar M.D.
• Nina Franklin
• Patricia Ann Franzblau, L.C.S.W.
• Fred Sufficool & Dan Griffin PTRS (Technician Support Services Industry, TSSI Home Medical Equipment)
• Frederick W Close, MD, Inc
• Bria Freeman, OTR/L
• Hannah Freeman, MA, APCC
• Labrie S French-Asaro, MFT
• Fresenius Medical Care Balboa II, LLC (Fresenius Medical Care Balboa la Mesa)
• William Eugene Friedel, M.D.

• Emergency Medicine Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.