Active NPI
Pamela Sue Earles, NP
- Family Nurse Practitioner
- Minnetonka, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 19263
- Practice address
- 9900 Bren Rd E
Minnetonka, MN 55343-9664 - Phone
- (423) 361-4818
- NPI assigned
- Jul 11, 2014
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 74451 | TN | |
| Family Nurse Practitioner | 363LF0000X | 19263 | TN | Primary |
Addresses
Primary practice location
9900 Bren Rd E
Minnetonka, MN 55343-9664
Mailing address
713 New Beason Well Rd
Kingsport, TN 37660-2805
Phone (423) 361-4818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74451 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Medical Clinic PLLC | Current | Accepting new patients | |
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Wellmont Medical Associates Inc | Current | Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current | Accepting new patients |
Locations
1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000
1116 Highway 11 W
Church Hill, TN 37642
Phone (423) 226-5109
111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197
130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150
105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220
401 Scenic Dr
Rogersville, TN 37857
Phone (423) 272-7261
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Spring Hill, TN
- NPI 1134452865
-
- Pulmonary Disease Physician
- Kingsport, TN
- NPI 1780986257
-
- Rural Health Clinic/Center
- Chapel Hill, TN
- NPI 1316602774
-
- Psychiatry Physician
- Johnson City, TN
- NPI 1275393522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599868800000",
"number": "1487061313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 NEW BEASON WELL RD",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376602805",
"telephone_number": "423-361-4818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 BREN RD E",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439664",
"telephone_number": "423-361-4818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EARLES",
"first_name": "PAMELA",
"middle_name": "SUE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-11",
"last_updated": "2020-09-12",
"certification_date": "2020-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "74451",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "19263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.