Individual provider Active NPI

Tammy Micheal Pearse, CSFA

  • Surgical Assistant
  • Lexington, KY
National Provider Identifier
1114778966
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
SA390 Issued in KY
Practice address
800 Rose St
Lexington, KY 40536-7001
Phone
(859) 323-5631
NPI assigned
Mar 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X SA390 KY Primary

Addresses

Primary practice location

800 Rose St
Lexington, KY 40536-7001

Mailing address

501 Hill N Dale Rd
Lexington, KY 40503-2212
Phone (859) 492-6689

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA390KYMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1114778966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 HILL N DALE RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032212",
            "telephone_number": "859-492-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405367001",
            "telephone_number": "859-323-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSE",
        "first_name": "TAMMY",
        "middle_name": "MICHEAL",
        "credential": "CSFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "KY",
            "license": "SA390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.