Active NPI
Mary Kay Fadden, PA-C
- Physician Assistant
- Nashville, TN
National Provider Identifier
1265418966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA0000001679
- Practice address
- 617 S 8TH St
Nashville, TN 37206-3819 - Phone
- (615) 228-8902
- Fax
- (615) 226-2679
- NPI assigned
- Dec 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA0000001679 | TN | Primary |
Addresses
Primary practice location
617 S 8TH St
Nashville, TN 37206-3819
Mailing address
601 W Due West Ave
Madison, TN 37115-4423
Phone (615) 425-3333
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0000001679 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292457600000",
"number": "1265418966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 W DUE WEST AVE",
"city": "MADISON",
"state": "TN",
"postal_code": "371154423",
"telephone_number": "615-425-3333",
"fax_number": "615-425-3348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 S 8TH ST",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372063819",
"telephone_number": "615-228-8902",
"fax_number": "615-226-2679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADDEN",
"first_name": "MARY",
"middle_name": "KAY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-15",
"last_updated": "2010-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "PA0000001679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.