Active NPI
Kathryn Repass Freedman, DMD
- General Practice Dentistry
- Greenville, SC
National Provider Identifier
1962675116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4063
- Practice address
- 112 Skyview Drive
Greenville, SC 29607 - Phone
- (864) 250-8126
- NPI assigned
- Apr 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4063 | SC | Primary |
Addresses
Primary practice location
112 Skyview Drive
Greenville, SC 29607
Mailing address
PO Box 5616
Den 112-316 Ms #1122
Greenville, SC 29606-5616
Phone (864) 250-8712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4063 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Donald L. Herndon DMD PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Greenville, SC
- NPI 1982348504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1962675116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5616",
"address_2": "DEN 112-316 MS #1122",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296065616",
"telephone_number": "864-250-8712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 SKYVIEW DRIVE",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "29607",
"telephone_number": "864-250-8126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEDMAN",
"first_name": "KATHRYN",
"middle_name": "REPASS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-09",
"last_updated": "2021-12-01",
"certification_date": "2021-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "4063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.