Individual provider Active NPI

Tresselyn Douglas Adams, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rome, GA
National Provider Identifier
1104051168
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN112304 Issued in GA
Practice address
1345 Redmond Cir NW
Rome, GA 30165-1307
Phone
(910) 742-9243
Fax
(888) 746-1787
NPI assigned
May 20, 2009
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN112304 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN112304 GA Primary

Addresses

Primary practice location

1345 Redmond Cir NW
Rome, GA 30165-1307

Mailing address

PO Box 538622
Atlanta, GA 30353-8622
Phone (910) 742-9243

Other practice location 1

1007 Memorial Dr
Griffin, GA 30223-4445
Phone (770) 467-4715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1104051168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538622",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303538622",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 REDMOND CIR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651307",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Griffin",
            "state": "GA",
            "postal_code": "302234445",
            "country_code": "US",
            "telephone_number": "770-467-4715",
            "fax_number": "770-229-3170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "TRESSELYN",
        "middle_name": "DOUGLAS",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN112304",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN112304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.