Individual provider Active NPI

Stephanie A Passons, PA

  • Medical Physician Assistant
  • Goodlettsville, TN
National Provider Identifier
1447583760
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1747 Issued in TN
Practice address
450 Professional Park Dr
Suite C
Goodlettsville, TN 37072-2180
Phone
(615) 859-1440
Fax
(615) 859-0145
NPI assigned
Sep 18, 2009
Last updated
Sep 18, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1747 TN Primary

Addresses

Primary practice location

450 Professional Park Dr
Suite C
Goodlettsville, TN 37072-2180

Mailing address

PO Box 710
Goodlettsville, TN 37070-0710
Phone (615) 859-1440

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1747TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson and Moor, LLC PastSince Oct 5, 2012 Accepting new patients
Robertson County Physical Medicine LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1447583760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370700710",
            "telephone_number": "615-859-1440",
            "fax_number": "615-859-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PROFESSIONAL PARK DR",
            "address_2": "SUITE C",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370722180",
            "telephone_number": "615-859-1440",
            "fax_number": "615-859-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSONS",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-18",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodlettsville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; 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.