Thomas J Pemberton

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN196326 Issued in AZ

Practice address

618 S Madison Dr
Tempe, AZ 85281-7248

Phone

(480) 784-1514

NPI assigned

Oct 16, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: thomas.pemberton.p1@direct.lafrontera-empact.nextgenshare.com

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.

• Empact - Suicide Prevention Center

  • Community/Behavioral Health Agency
  • San Tan Valley, AZ
  • NPI 1215311378
  NPD (past)
• Empact Suicide Prevention Center Inc

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1659414969
  NPD (past)
• Empact-Suicide Prevention Center

  • Community/Behavioral Health Agency
  • Tempe, AZ
  • NPI 1609071646
  NPD (past)

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1528600012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11518 E APACHE TRL STE 129",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851203572",
            "telephone_number": "480-317-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S MADISON DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852817248",
            "telephone_number": "480-784-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "THOMAS",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-16",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN196326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatrics Healthcare Associates
• Lora Pedrosa, PMHNP-BC
• Serena Jae Pedroza, MS SLP
• Haritheesan Peethambaran, PTA
• Francisco Pelayo, MD
• Alison Nicole Penas, PT
• Shane Michael Pendleton, CRNA
• Pensieve Counseling Services LLC
• Kelly Lynne Peper, RD
• Wesley G Perdue, MS, LPC

• Psychiatric/Mental Health Registered Nurse in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Psychiatric/Mental Health Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.
• 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.