Organization Active NPI

Seasons Family Medicine, PLLC

  • Primary Care Clinic/Center
  • Cookeville, TN
National Provider Identifier
1497162382
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
40043 Issued in TN
Legal business name
SEASONS FAMILY MEDICINE, PLLC
Practice address
1611 S Jefferson Ave
Cookeville, TN 38506-5566
Phone
(931) 644-4664
Fax
(833) 992-2128
NPI assigned
Jul 13, 2014
Last updated
Apr 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Authorized official

Name
Dr. Pamela J Sanders, MDNPI 1295706356
Title
Physician
Phone
(931) 644-4664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 40043 TN Primary

Addresses

Primary practice location

1611 S Jefferson Ave
Cookeville, TN 38506-5566

Mailing address

1611 S Jefferson Ave
Cookeville, TN 38506-5566
Phone (931) 644-0262

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pamela.sanders.1@22572.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141001002738 TN Part B Supplier - Clinic/Group Practice 5991925554 Receives reassigned benefits from 3 practitioners
Practice locations: Cookeville, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2082439Seasons Family Medicine, PLLC1611 S Jefferson Ave, Cookeville, TN 38506Provider-performed microscopyAug 13, 2026

National Provider Directory

National Provider Directory

Locations

1611 S Jefferson Ave
Cookeville, TN 38506
Phone (931) 644-0262

43 Church Ave
Cookeville, TN 38501
Phone (931) 644-0262

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22572/brand/1/csg/1/fhir/r4
  • Direct secure messaging: pamela.sanders.1@22572.direct.athenahealth.com

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1405209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1497162382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S JEFFERSON AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385065566",
            "telephone_number": "931-644-0262",
            "fax_number": "833-992-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S JEFFERSON AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385065566",
            "telephone_number": "931-644-4664",
            "fax_number": "833-992-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASONS FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-13",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "931-644-4664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "40043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pamela.sanders.1@22572.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1611 S Jefferson Ave",
            "city": "Cookeville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "385065566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.