Individual provider Active NPI

Dana Faye Emberton-Tinius, APRN

  • Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1124760657
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3018235 Issued in KY
Practice address
225 Natchez Trace Ave
Bowling Green, KY 42103-7995
Phone
(270) 783-3573
Fax
(270) 783-4081
NPI assigned
Apr 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1054145 KY
Nurse Practitioner 363L00000X 3018235 KY Primary

Addresses

Primary practice location

225 Natchez Trace Ave
Bowling Green, KY 42103-7995

Mailing address

225 Natchez Trace Ave
Bowling Green, KY 42103-7995
Phone (270) 783-3573

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
I20230203001128 KY Practitioner - Nurse Practitioner 7618349416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bowling Green Warren County Primary Care Center, Inc.Group PAC ID 3779521612, 8 clinicians

Practice addresses (Care Compare)

225 Natchez Trace Ave
Bowling Green, KY 42103-7995
Phone (270) 783-3573

Hospital & facility affiliations

  • The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1054145KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bowling Green Warren County Primary Care Center, Inc. CurrentSince Dec 5, 2022 Accepting new patients

Locations

615 7th Ave
Bowling Green, KY 42101
Phone (270) 783-3573

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 1

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": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1124760657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 NATCHEZ TRACE AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037995",
            "telephone_number": "270-783-3573",
            "fax_number": "270-783-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NATCHEZ TRACE AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037995",
            "telephone_number": "270-783-3573",
            "fax_number": "270-783-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMBERTON-TINIUS",
        "first_name": "DANA",
        "middle_name": "FAYE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1054145",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3018235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.