Active NPI
Tonya C. Krantz, PA-C
- Physician Assistant
- Clarksville, TN
National Provider Identifier
1457558512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 000263
- Practice address
- 1822 Memorial Dr
Clarksville, TN 37043-4605 - Phone
- (931) 552-8012
- Fax
- (931) 551-3118
- NPI assigned
- Jun 29, 2007
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000263 | TN | Primary |
Addresses
Primary practice location
1822 Memorial Dr
Clarksville, TN 37043-4605
Mailing address
1822 Memorial Dr
Clarksville, TN 37043-4605
Phone (931) 552-8012
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3728817 | Medicaid | TN | |
| 4102314 | Other | TN | BLUE CROSS BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000263 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457558512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1822 MEMORIAL DR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370434605",
"telephone_number": "931-552-8012",
"fax_number": "931-551-3118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1822 MEMORIAL DR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370434605",
"telephone_number": "931-552-8012",
"fax_number": "931-551-3118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRANTZ",
"first_name": "TONYA",
"middle_name": "C.",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "000263",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3728817",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "4102314",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.