Individual provider Active NPI

Tamela R. King, C-FNP

  • Nurse Practitioner
  • Proctorville, OH
National Provider Identifier
1265439384
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.05133-NP Issued in OH
Practice address
10777 County Road 107
Proctorville, OH 45669-8130
Phone
(740) 302-0541
Fax
(740) 867-0017
NPI assigned
Jul 5, 2005
Last updated
Jan 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.05133-NP OH Primary
Nurse Practitioner 363L00000X 37484 WV

Addresses

Primary practice location

10777 County Road 107
Proctorville, OH 45669-8130

Mailing address

305 N 5TH St
Ironton, OH 45638-1578
Phone (740) 532-3534

Other identifiers 3

IdentifierTypeStateIssuer
78012846MedicaidKY
7102062000MedicaidWV
2315300MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080301000132 OH Practitioner - Nurse Practitioner 6204735434 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
JC Edwards School of Medicine, Marshall University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ironton and Lawrence County Area Community Action OrganizationGroup PAC ID 8820902497, shared by 8 NPIs, 17 clinicians

Practice addresses (Care Compare)

10777 County Rd
Proctorville, OH 45669-8130
Phone (740) 302-0541

13804 State Route 141
Kitts Hill, OH 45645-8848
Phone (740) 643-2082

1408 Campbell Dr
Ironton, OH 45638-2301
Phone (740) 534-9195

305 N 5TH St
Ironton, OH 45638-1578

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.05133-NPOHMDNurse Practitioner
37484WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ironton & Lawrence County Area Community Action Organization CurrentSince Apr 1, 2013 Accepting new patients
Ironton & Lawrence County Area Community Action Organization Current Accepting new patients
Ironton & Lawrence County Area Community Action Organization Current Accepting new patients
Ironton & Lawrence County Area Community Action Organization CurrentSince Apr 1, 2013 Accepting new patients
Ironton & Lawrence County Area Community Action Organization CurrentSince Mar 19, 2010 Accepting new patients
Ironton & Lawrence County Area Community Action Organization Current Accepting new patients
Ironton & Lawrence County Area Community Action Organization CurrentSince Mar 19, 2010 Accepting new patients
Ironton & Lawrence County Area Community Action Organization CurrentSince Apr 1, 2013 Accepting new patients
The Center for Pain Relief Tri State PLLC Nurse Practitioner Past Accepting new patients
Pain Care, PLLC Past Accepting new patients

Locations

717 3rd Ave
Chesapeake, OH 45619
Phone (740) 867-6687

717 3rd Ave
#C
Chesapeake, OH 45619
Phone (740) 867-6687

223 Carlton Davidson Ln
Coal Grove, OH 45638
Phone (740) 532-3048

120 N 3rd St
Ironton, OH 45638
Phone (740) 532-7855

1408 Campbell Dr
#201
Ironton, OH 45638
Phone (740) 534-9195

2325 County Road 26
Unit C
Ironton, OH 45638
Phone (740) 643-8688

305 N 5th St
Ironton, OH 45638

13804 State Route 141
Kitts Hill, OH 45645
Phone (740) 643-0234

10777 County Road 107
Proctorville, OH 45669
Phone (740) 302-0541

55 Township Road 508 E
South Point, OH 45680
Phone (740) 377-2712

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

2900 1st Ave
Fl St
Huntington, WV 25702
Phone (304) 525-7246

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1265439384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N 5TH ST",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456381578",
            "telephone_number": "740-532-3534",
            "fax_number": "740-532-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 COUNTY ROAD 107",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456698130",
            "telephone_number": "740-302-0541",
            "fax_number": "740-867-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "TAMELA",
        "middle_name": "R.",
        "credential": "C-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.05133-NP",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "37484",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78012846",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7102062000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2315300",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Proctorville, OH

Sources for this page

Verify at the official NPI Registry.