Individual provider Active NPI

Tamara Dawn Niemeier, ARNP

  • Pediatric Nurse Practitioner
  • Corbin, KY
National Provider Identifier
1265439202
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3002218 Issued in KY
Practice address
57 Summit Dr
Corbin, KY 40701-2746
Phone
(606) 528-9700
Fax
(606) 528-8423
NPI assigned
Jul 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3002218 KY Primary

Addresses

Primary practice location

57 Summit Dr
Corbin, KY 40701-2746

Mailing address

57 Summit Dr
Corbin, KY 40701-2746
Phone (606) 528-9700

Other identifiers 1

IdentifierTypeStateIssuer
78001344MedicaidKY

Other names 1

  • Tamara Dawn Smith Former name

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

State licenses

LicenseStateTypeSpecialty
3002218KYMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: tniemeier704476@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1265439202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 SUMMIT DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012746",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 SUMMIT DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012746",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMEIER",
        "first_name": "TAMARA",
        "middle_name": "DAWN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-06",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3002218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78001344",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "SMITH",
            "middle_name": "DAWN",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.