Tammy Jo Parks, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

261262--1 Issued in NY

Practice address

924 Riggs Ave
Watertown, NY 13601-3842

Phone

(315) 955-5235

NPI assigned

Jul 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tammy J Vance Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1285832873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 RIGGS AVE",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013842",
            "telephone_number": "315-955-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 RIGGS AVE",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013842",
            "telephone_number": "315-955-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "TAMMY",
        "middle_name": "JO",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "261262--1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02528009",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "VANCE",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aeklavya Panjali, DDS DDS
• Janet L. Parcell Mitchell, PT, DPT, ATC, CSCS
• Eunmi Park
• Kimberly Ann Parker, OPTICIAN
• Stephanie Parks, PTA
• Parkview Noco RX, LLC
• Jana Parody, RN
• Elizabeth A Parris, MSW
• Jitendra A Patel, DDS
• Sonal Patel

• Licensed Practical Nurse in Watertown, NY
• Providers in Watertown, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.