Individual provider Active NPI

Kellie Christine Freeman, PA-C

  • Physician Assistant
  • Clearwater, FL
National Provider Identifier
1962921577
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010705 Issued in VA
Practice address
300 Pinellas St
Clearwater, FL 33756-3804
Phone
(727) 298-6612
Fax
(727) 461-8085
NPI assigned
Sep 14, 2017
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110010705 VA Primary
Emergency Medicine Physician 207P00000X 0110010705 VA
Family Medicine Physician 207Q00000X 0110010705 VA
Internal Medicine Physician 207R00000X 0110010705 VA
Pediatrics Physician 208000000X 0110010705 VA
Physical Medicine & Rehabilitation Physician 208100000X 0110010705 VA
Diagnostic Radiology Physician 2085R0202X 0110010705 VA
Surgery Physician 208600000X 0110010705 VA

Addresses

Primary practice location

300 Pinellas St
Clearwater, FL 33756-3804

Mailing address

2995 Drew St
Clearwater, FL 33759-3012
Phone (727) 315-7496

Other practice location 1

18688 Jeb Stuart Hwy
Stuart, VA 24171-1559
Phone (276) 692-9020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171211000654 FL Practitioner - Physician Assistant 5597023002 Reassigns benefits to 6 organizations
I20260403002365 VA Practitioner - Physician Assistant 5597023002 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18688 Jeb Stuart Hwy
Stuart, VA 24171

3643 S 89TH St
Milwaukee, WI 53228-1533

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110010705VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Urgent Care, LLC Family Medicine Current Accepting new patients

Locations

2995 Drew St
Clearwater, FL 33759
Phone (727) 315-7496

4821 US Highway 19
Ste 5
New Port Richey, FL 34652
Phone (727) 851-9650

2331 4th St N
St Petersburg, FL 33704
Phone (727) 593-9848

Networks

  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kellie.freemanpac@direct.mybaycare.org

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1962921577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-315-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-298-6612",
            "fax_number": "727-461-8085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18688 Jeb Stuart Hwy",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "VA",
            "postal_code": "241711559",
            "country_code": "US",
            "telephone_number": "276-692-9020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "KELLIE",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010705",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0110010705",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0110010705",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0110010705",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0110010705",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0110010705",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0110010705",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0110010705",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.