Individual provider Active NPI

Pamela F Tolley

  • Registered Nurse
  • Lewisburg, WV
National Provider Identifier
1609532969
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
TEMP004456 Issued in WV
Practice address
2947 Jefferson St N Ste 2
Lewisburg, WV 24901-5796
Phone
(304) 645-7420
Fax
(304) 645-7112
NPI assigned
Nov 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X TEMP004456 WV Primary

Addresses

Primary practice location

2947 Jefferson St N Ste 2
Lewisburg, WV 24901-5796

Mailing address

2947 Jefferson St N Ste 2
Lewisburg, WV 24901-5796
Phone (304) 645-7420

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TEMP004456WVMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1609532969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2947 JEFFERSON ST N STE 2",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249015796",
            "telephone_number": "304-645-7420",
            "fax_number": "304-645-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2947 JEFFERSON ST N STE 2",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249015796",
            "telephone_number": "304-645-7420",
            "fax_number": "304-645-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLEY",
        "first_name": "PAMELA",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-12-09",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "TEMP004456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.