Active NPI
Pamela B Mazza, NP
- Nurse Practitioner
- Charleston, SC
National Provider Identifier
1417904301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 712
- Practice address
- 109 Bee St
Charleston, SC 29401-5703 - Phone
- (843) 789-7025
- Fax
- (843) 789-6109
- NPI assigned
- May 27, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | APN712 | SC | |
| Nurse Practitioner | 363L00000X | 712 | SC | Primary |
Addresses
Primary practice location
109 Bee St
Charleston, SC 29401-5703
Mailing address
109 Bee St
Charleston, SC 29401-5703
Phone (843) 789-7025
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00648613 | Other | SC | RAILROAD MEDICARE # |
| NP0749 | Medicaid | SC |
Other names 1
- Pamela Bright-Chamberr
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
| License | State | Type | Specialty |
|---|---|---|---|
| 712 | SC | MD | Addiction (Substance Use Disorder) Counselor |
| APN712 | SC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lowcountry Medical Associates | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Moncks Corner Primary Care
- Internal Medicine Physician
- Moncks Corner, SC
- NPI 1790735975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482969600000",
"number": "1417904301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015703",
"telephone_number": "843-789-7025",
"fax_number": "843-789-6109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015703",
"telephone_number": "843-789-7025",
"fax_number": "843-789-6109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZZA",
"first_name": "PAMELA",
"middle_name": "B",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-27",
"last_updated": "2016-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SC",
"license": "APN712",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "712",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE #",
"identifier": "P00648613",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP0749",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PAMELA",
"last_name": "BRIGHT-CHAMBERR",
"credential": "ANP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.