NPIMap

Organization Active NPI

Freedom Wellness, LLC

  • Clinical Medical Laboratory
  • Virginia Beach, VA
National Provider Identifier
1891384061
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
FREEDOM WELLNESS, LLC
Practice address
337 Edwin Dr Ste 200
Virginia Beach, VA 23462-4560
Phone
(757) 575-8627
NPI assigned
Jan 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Shavon Miller, LPNNPI 1598360331
Title
Director
Phone
(757) 575-8627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

337 Edwin Dr Ste 200
Virginia Beach, VA 23462-4560

Mailing address

5313 Macchonanchy St
Virginia Beach, VA 23464-8114
Phone (757) 575-8627

Other identifiers 1

IdentifierTypeStateIssuer
0Other0

Other names 1

  • Freedom Training Solutions Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL freedomwellness20@gmail.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

337 Edwin Dr
Ste 200
Virginia Beach, VA 23462
Phone (757) 575-8627

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1891384061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5313 MACCHONANCHY ST",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234648114",
            "telephone_number": "757-575-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 EDWIN DR STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624560",
            "telephone_number": "757-575-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SHAVON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-575-8627",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "freedomwellness20@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "337 Edwin Dr Ste 200",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234624560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Freedom Training Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.