Active NPI
Pamela J Garner, MS FNP
- Nurse Practitioner
- Elmwood, IL
National Provider Identifier
1306028212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209006839
- Practice address
- 120 W Main Street
Elmwood, IL 61529 - Phone
- (309) 742-2921
- Fax
- (309) 742-8411
- NPI assigned
- Dec 3, 2007
- Last updated
- Sep 29, 2010
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209006839 | IL | Primary |
Addresses
Primary practice location
120 W Main Street
Elmwood, IL 61529
Mailing address
PO Box 680
120 W Main Street
Elmwood, IL 61529
Phone (309) 742-2921
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7200613 | Other | IN | BLUE CROSS BLUE SHIELD |
Other names 1
- Miss Pamela J Johnson
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
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Francis Medical Center | Past | Accepting new patients | |
| Mark C. Baylor, M.D. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Elmwood, IL
- NPI 1437337342
-
dba Saint Francis Home Health
- Home Health Agency
- Peoria, IL
- NPI 1346281425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285718400000",
"number": "1306028212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 680",
"address_2": "120 W MAIN STREET",
"city": "ELMWOOD",
"state": "IL",
"postal_code": "61529",
"telephone_number": "309-742-2921",
"fax_number": "309-742-8411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 W MAIN STREET",
"city": "ELMWOOD",
"state": "IL",
"postal_code": "61529",
"telephone_number": "309-742-2921",
"fax_number": "309-742-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARNER",
"first_name": "PAMELA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "MS FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-03",
"last_updated": "2010-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209006839",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "7200613",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PAMELA",
"last_name": "JOHNSON",
"middle_name": "J",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Elmwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.