Individual provider Active NPI

Tamisha Pena, FNP

  • Family Nurse Practitioner
  • Eureka, NV
National Provider Identifier
1235546888
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002757 Issued in NV
Practice address
250 S Main St
Eureka, NV 89316-1513
Phone
(775) 237-5642
NPI assigned
Jul 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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 18792 TN
Family Nurse Practitioner 363LF0000X APRN002757 NV Primary

Addresses

Primary practice location

250 S Main St
Eureka, NV 89316-1513

Mailing address

250 S Main St
Eureka, NV 89316-1513
Phone (775) 237-5642

Other practice location 1

9408 Apison Pike Ste 174
Ooltewah, TN 37363-5977
Phone (423) 396-9893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20180619001884 NV Practitioner - Nurse Practitioner 8628299377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William Bee Ririe HospitalGroup PAC ID 9335051747, 40 clinicians

Practice addresses (Care Compare)

1500 Ave H
Ely, NV 89301-2615
Phone (775) 289-3612

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
37.4 of 100Reported as group
Quality
27.48
Improvement activities
0
Cost
71.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN002757NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
William Bee Ririe Retail Pharmacy CurrentSince May 8, 2018 Accepting new patients
William Bee Ririe Hospital Family CurrentSince May 8, 2018 Accepting new patients
William Bee Ririe Hospital Current Accepting new patients
William Bee Ririe Hospital Past Accepting new patients

Locations

1500 Avenue H
Ely, NV 89301
Phone (775) 289-3001

Organizations & group practices 4

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 4

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": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1235546888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S MAIN ST",
            "city": "EUREKA",
            "state": "NV",
            "postal_code": "893161513",
            "telephone_number": "775-237-5642",
            "fax_number": "775-237-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S MAIN ST",
            "city": "EUREKA",
            "state": "NV",
            "postal_code": "893161513",
            "telephone_number": "775-237-5642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9408 Apison Pike Ste 174",
            "address_purpose": "LOCATION",
            "city": "Ooltewah",
            "state": "TN",
            "postal_code": "373635977",
            "country_code": "US",
            "telephone_number": "423-396-9893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "TAMISHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18792",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, NV

Sources for this page

Verify at the official NPI Registry.