Individual provider Active NPI

Connie Lynn Tramel, NP

  • Primary Care Nurse Practitioner
  • Calhoun City, MS
National Provider Identifier
1336333772
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R619272 Issued in MS
Practice address
105 Legion Ave
Calhoun City, MS 38916-6601
Phone
(601) 825-7280
Fax
(601) 825-8130
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R619272 MS Primary

Addresses

Primary practice location

105 Legion Ave
Calhoun City, MS 38916-6601

Mailing address

PO Box 24116
Jackson, MS 39225-4116
Phone (601) 825-7280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20051103000716 MS Practitioner - Nurse Practitioner 6800814369 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R619272MSMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Care Clinic, Inc. Current Accepting new patients
Renal Care Group Tupelo, LLC PastSince Jan 3, 2021 Accepting new patients

Locations

4635 Highway 80 E
Pearl, MS 39208
Phone (601) 933-2500

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.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1336333772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24116",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392254116",
            "telephone_number": "601-825-7280",
            "fax_number": "601-825-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 LEGION AVE",
            "city": "CALHOUN CITY",
            "state": "MS",
            "postal_code": "389166601",
            "telephone_number": "601-825-7280",
            "fax_number": "601-825-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAMEL",
        "first_name": "CONNIE",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "R619272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun City, MS

Sources for this page

Verify at the official NPI Registry.