Individual provider Active NPI

Trampas S Nolan, ARNP

  • Family Nurse Practitioner
  • Pineville, KY
National Provider Identifier
1033144191
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3004312 Issued in KY
Practice address
222 W Tennessee Ave
Pineville, KY 40977-1737
Phone
(606) 654-6210
Fax
(606) 654-6220
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3004312 KY Primary

Addresses

Primary practice location

222 W Tennessee Ave
Pineville, KY 40977-1737

Mailing address

222 W Tennessee Ave
Pineville, KY 40977-1737
Phone (606) 654-6210

Other identifiers 1

IdentifierTypeStateIssuer
78012564MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000741 KY Practitioner - Nurse Practitioner 8921072091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Family Practice PSCGroup PAC ID 0941550149, 3 clinicians

Practice addresses (Care Compare)

222 W Tennessee Ave
Pineville, KY 40977-1737
Phone (606) 654-6210

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3004312KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Family Practice PSC Family CurrentSince May 10, 2018 Accepting new patients

Locations

222 W Tennessee Ave
Pineville, KY 40977
Phone (606) 337-3123

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DECFBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/DECFBD/Endpoint/DECFBD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southeast Family Practice PSCPineville, KY, CCN 183803 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
May 10, 2018
May 10, 2018
May 10, 2018
May 10, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 5

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1033144191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W TENNESSEE AVE",
            "city": "PINEVILLE",
            "state": "KY",
            "postal_code": "409771737",
            "telephone_number": "606-654-6210",
            "fax_number": "606-654-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W TENNESSEE AVE",
            "city": "PINEVILLE",
            "state": "KY",
            "postal_code": "409771737",
            "telephone_number": "606-654-6210",
            "fax_number": "606-654-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "TRAMPAS",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3004312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78012564",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, KY

Sources for this page

Verify at the official NPI Registry.