Carol Ivy Reynolds-Freeman, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

D0027958 Issued in MD

Practice address

4 W Rolling Crossroads
Suite 100
Baltimore, MD 21228-6280

Phone

(410) 869-0100

Fax

(410) 869-0460

NPI assigned

Oct 31, 2005

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 2

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crfreema@direct.lifebridgehealth.org

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.

• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment NPD
• Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Lutherville, MD
  • NPI 1740086149
  NPD
• Lifebridge Community Physicians, Inc

  • Pulmonary Disease Physician
  • Pikesville, MD
  • NPI 1306182621
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1841281706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 REISTERSTOWN RD",
            "address_2": "SUITE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212086320",
            "telephone_number": "410-602-9850",
            "fax_number": "410-602-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W ROLLING CROSSROADS",
            "address_2": "SUITE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212286280",
            "telephone_number": "410-869-0100",
            "fax_number": "410-869-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS-FREEMAN",
        "first_name": "CAROL",
        "middle_name": "IVY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "D0027958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316481100",
            "state": "MH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID",
            "identifier": "X963",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Azarcon Reyes, M.D.
• Regina M Reyes, CRNP
• Rosalie Reyes
• David Anthony Reymann, DPT
• Stewart Perez Reyna, MD
• Amy Reynolds, RDN
• Asia Evelyn Lee Reynolds, N/A
• Brian Reynolds
• Chelsea Reynolds, RD, LDN
• Cindy J Reynolds, LCSW-C

• Pediatric Adolescent Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatric Adolescent Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.