Individual provider Active NPI

Pam Lassiter, FNP-BC

  • Family Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1629374632
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2010013142 Issued in TN
Practice address
490 Dunlop LN
Clarksville, TN 37040-5007
Phone
(931) 245-7001
Fax
(931) 245-7069
NPI assigned
Feb 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2010013142 TN Primary

Addresses

Primary practice location

490 Dunlop LN
Clarksville, TN 37040-5007

Mailing address

PO Box 3799
Clarksville, TN 37043-3799
Phone (931) 245-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pam.lassiter.2@7977.direct.athenahealth.com Direct Premier Medical Group PC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110617000167 TN Practitioner - Nurse Practitioner 5092993238 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Medical Group PCGroup PAC ID 9739084088, 46 clinicians

Practice addresses (Care Compare)

490 Dunlop LN
Clarksville, TN 37040-5007
Phone (931) 245-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2010013142TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Urgent Care PLLC Family CurrentSince Jul 27, 2012 Accepting new patients
Hospital Medicine Services of TN, LLC Family CurrentSince Nov 17, 2024 Accepting new patients
Premier Medical Group PC CurrentSince Feb 18, 2021 Accepting new patients
Crossroads Urgent Care PLLC Family CurrentSince Jul 27, 2012 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

2300 Patterson St
#M
Nashville, TN 37203

2662 Memorial Blvd
Springfield, TN 37172
Phone (615) 380-8411

100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531

1802 N Jackson St
Ste 850
Tullahoma, TN 37388
Phone (931) 563-5501

Interoperability endpoints

  • Direct secure messaging: pam.lassiter.2@7977.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1629374632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3799",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370433799",
            "telephone_number": "931-245-7000",
            "fax_number": "931-245-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 DUNLOP LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405007",
            "telephone_number": "931-245-7001",
            "fax_number": "931-245-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSITER",
        "first_name": "PAM",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-08",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "2010013142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pam.lassiter.2@7977.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "Premier Medical Group PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "490 Dunlop Ln",
            "city": "Clarksville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370405007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.