Organization Active NPI

Freedmens Healthcare LLC

  • Family Medicine Physician
  • Bowie, MD
National Provider Identifier
1972193985
Registry record updated Jan 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FREEDMENS HEALTHCARE LLC
Practice address
9605 Oxbridge Way
Bowie, MD 20721-3035
Phone
(704) 713-4403
NPI assigned
Jan 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2021

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

Authorized official

Name
Kenyon Chavis, MD
Title
Member
Phone
(704) 713-4403

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9605 Oxbridge Way
Bowie, MD 20721-3035

Mailing address

9605 Oxbridge Way
Bowie, MD 20721-3035
Phone (704) 713-4403

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611360000000",
    "number": "1972193985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9605 OXBRIDGE WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207213035",
            "telephone_number": "704-713-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9605 OXBRIDGE WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207213035",
            "telephone_number": "704-713-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDMENS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-23",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A",
        "authorized_official_last_name": "CHAVIS",
        "authorized_official_first_name": "KENYON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "704-713-4403",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.