Pamela Macedonia, APRN PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4010515 Issued in KY

Practice address

1013 Master St
Corbin, KY 40701-1065

Phone

(606) 280-4000

Fax

(833) 222-3797

NPI assigned

Nov 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Pamela Gray Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jaynes Family PracticeGroup PAC ID 3779992573, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pamelamacedonia@jaynes.medentdirect.com

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.

• Jaynes Family Practice

  • Rural Health Clinic/Center
  • Corbin, KY
  • NPI 1184228553
  Medicare reassignment Care Compare group NPD
• Jaynes Family Practice South LLC

  • Family Nurse Practitioner
  • Corbin, KY
  • NPI 1245943356
  NPD (past)

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1386417939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 MASTER ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011065",
            "telephone_number": "606-280-4000",
            "fax_number": "833-222-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 MASTER ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011065",
            "telephone_number": "606-280-4000",
            "fax_number": "833-222-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEDONIA",
        "first_name": "PAMELA",
        "credential": "APRN PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4010515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "GRAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paige R Lunsford, BA
• Kristin Luntsford
• Ashley Luttrell
• Tara Lane Lynch-Towe, MSW
• Stephanie Marie Lynch, BA
• Mackey Vision Center PSC
• Mackey Vision Center PSC
• Benjamin Lee Mackey, M.D.
• Robert Edward Mackey, O.D.
• Chasity Mafnas

• Psychiatric/Mental Health Nurse Practitioner in Corbin, KY
• Providers in Corbin, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.