Individual provider Active NPI

Pamela L Peterman, NP

  • Family Nurse Practitioner
  • Cartersville, GA
National Provider Identifier
1316928872
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN093618 NP Issued in GA
Practice address
572 W Main St
Cartersville, GA 30120-3469
Phone
(770) 386-4161
Fax
(770) 386-9364
NPI assigned
Nov 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN093618 NP GA Primary

Addresses

Primary practice location

572 W Main St
Cartersville, GA 30120-3469

Mailing address

PO Box 2407
Cartersville, GA 30120-1691
Phone (770) 386-4161

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
RN093618 NPGAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Donald C. Evans, M.D., P.C. Past Accepting new patients
Ravens Nest Foundation Inc PastSince Mar 29, 2020 Accepting new patients
James a. Sexson, M.D. LLC Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1316928872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2407",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301201691",
            "telephone_number": "770-386-4161",
            "fax_number": "770-386-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 W MAIN ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203469",
            "telephone_number": "770-386-4161",
            "fax_number": "770-386-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "PAMELA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN093618 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.