Pamela Leeann Kersey

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

36580 Issued in TN

Practice address

886 Highway 411 N
Etowah, TN 37331-1912

Phone

(423) 263-3600

Fax

(423) 263-3601

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

State licenses

Practice roles

Locations

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.

• National Physicians PC

  • Adult Medicine Physician
  • Knoxville, TN
  • NPI 1780112805
  Medicare reassignment NPD
• McMinn Medical Imaging, PC

  • Diagnostic Radiology Physician
  • Athens, TN
  • NPI 1336164532
  NPD (past)
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1023064151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 SHANNON RD",
            "address_2": "SUITE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076322",
            "telephone_number": "919-403-2028",
            "fax_number": "919-419-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 HIGHWAY 411 N",
            "city": "ETOWAH",
            "state": "TN",
            "postal_code": "373311912",
            "telephone_number": "423-263-3600",
            "fax_number": "423-263-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSEY",
        "first_name": "PAMELA",
        "middle_name": "LEEANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "36580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Allan Anderson
• Jeffrey Allan Anderson
• Lauren Jenkins
• K-VA-T Food Stores Inc
• Zachary Kenney
• Ghazali Ataullah Khan, MD
• Kyngdom Inspirations, LLC
• Jessie Lovingood
• Madisonville Primary Care Group PLLC
• Steve M McCaslin, DPH

• Emergency Medicine Physician in Etowah, TN
• Providers in Etowah, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.