Edward Shane Trantham, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

219546 Issued in AZ

Practice address

2109 Navajo Blvd
Holbrook, AZ 86025-1822

Phone

(928) 524-2851

NPI assigned

Nov 29, 2018

Last updated

Mar 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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 AZ

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062
• Little Colorado Medical Center Hospital, Winslow, AZ, CCN 031311

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• El Rio Santa Cruz Neighborhood Health Center, Inc

  dba El Rio Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1487602736
  Medicare reassignment
• North Country Healthcare Inc

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1053587261
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1073583472
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Show Low, AZ
  • NPI 1073740098
  NPD
• North Country Healthcare, Inc.

  dba Flagstaff Pediatric Care

  • Pediatrics Physician
  • Flagstaff, AZ
  • NPI 1669911764
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Summit Healthcare Association

  dba Summit Healthcare Oncology Center

  • Oncology Clinic/Center
  • Show Low, AZ
  • NPI 1083736128

  Hospital

  Care Compare affiliation
• Summit Healthcare Association

  dba Summit Healthcare Regional Medical Center

  • Rural Acute Care Hospital
  • Show Low, AZ
  • NPI 1144209271
  Care Compare affiliation
• Summit Healthcare Medical Associates

  dba Family Medicine at Bison Ranch

  • Rural Health Clinic/Center
  • Overgaard, AZ
  • NPI 1770700767

  Hospital

  Care Compare affiliation
• Winslow Memorial Hospital Inc

  dba Little Colorado Medical Center

  • Critical Access Hospital
  • Winslow, AZ
  • NPI 1477653889
  Care Compare affiliation

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1043780349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3630",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860033630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 NAVAJO BLVD",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860251822",
            "telephone_number": "928-524-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRANTHAM",
        "first_name": "EDWARD",
        "middle_name": "SHANE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-29",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "219546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela D Stribling, CCC-SLP
• Stuart Eye Centre
• Ryan Craig Stuart, O.D.
• V Craig Stuart, OD
• Summit Healthcare Medical Associates
• Nathan Velez, PH.D
• Vitegent Healthcare Inc. (Petrified Forest Medical Center)
• Margaret Abril Webb, LCSW

• Family Nurse Practitioner in Holbrook, AZ
• Providers in Holbrook, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.