Tammy Renea Chavis-Watson, FNP
Individual provider Active NPI Family Nurse Practitioner · Fairmont, NC
NPI 1558030684 · NPPES record last updated Feb 26, 2024
Key facts
- NPI
- 1558030684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5015285 (NC)
- Practice address
- 1516 Pleasant Hope Rd
Fairmont, NC 28340-8990 - Phone
- (107) 367-3759
- NPI assigned
- Sep 11, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Unc Physicians Network LLC
Practice addresses (Care Compare)
2934 N Elm St
Suite B
Lumberton, NC 28358-2987
Phone (910) 272-1175
Hospital & facility affiliations
- Southeastern Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211206000055 | NC | Practitioner - Nurse Practitioner | 1153711288 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5015285 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unc Physicians Network LLC | Current |
Accepting new patients | |
| Unc Physicians Network LLC | Current | Accepting new patients |
Locations
6013 Farrington Rd
Ste 101
Chapel Hill, NC 27517
Phone (919) 957-6610
940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123
37 Pineville Blvd
#102
Clayton, NC 27527
Phone (919) 346-8680
34 Healthpark Way
Ste 100
Clayton, NC 27520
Phone (919) 585-8850
5070 Fayetteville Rd
Lumberton, NC 28358
Phone (910) 738-9577
2934 N Elm St
Ste B
Lumberton, NC 28358
Phone (910) 272-1175
6701B NC Highway 135
Mayodan, NC 27027
Phone (336) 635-6816
5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110
923 W 3rd St
Ste C
Pembroke, NC 28372
Phone (910) 521-0564
51 Mosaic Blvd
Ste 100
Pittsboro, NC 27312
Phone (984) 215-6766
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5015285 | NC | Yes |
Addresses
Primary practice location
1516 Pleasant Hope Rd
Fairmont, NC 28340-8990
Mailing address
1516 Pleasant Hope Rd
Fairmont, NC 28340-8990
Phone (107) 367-3759
Other providers in Fairmont, NC
- Natural Morgan Breeden
- Mary Alexis Britt
- Olivia Naomie Bullard
- C & E Family Care Home LLC.
- Lionel Nelson Chamberlain
- Kaila Brooke Chavis
- Children'S Health of Carolina, PA
- Clyde Aaron Collins
- Cornerstone Treatment Faciltiy
- Wanda Jean Cox
All providers in Fairmont, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.