Individual provider Active NPI

Tamara Dawn Yoas, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Shelby Township, MI
National Provider Identifier
1629549159
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704267084 Issued in MI
Practice address
46960 Van Dyke Ave # 8144
Shelby Township, MI 48317-4378
Phone
(586) 726-9220
NPI assigned
Dec 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3016157 KY
Nurse Practitioner 363L00000X 202104987RN OR
Family Nurse Practitioner 363LF0000X 4704267084 MI Primary

Addresses

Primary practice location

46960 Van Dyke Ave # 8144
Shelby Township, MI 48317-4378

Mailing address

46960 Van Dyke Ave # 8144
Shelby Township, MI 48317-4378
Phone (586) 726-9220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190115002486 MI Practitioner - Nurse Practitioner 9931445772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flushing Urgent Care PLCGroup PAC ID 2961653803, 14 clinicians

Practice addresses (Care Compare)

700 S Main St Unit
101B Convenient Urgent Care
Lapeer, MI 48446-3082
Phone (810) 720-1200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704267084MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Assoc of Port Huron CurrentSince Jan 1, 2019 Accepting new patients
Flushing Urgent Care PLC CurrentSince Feb 23, 2024 Accepting new patients

Locations

6020 W Pierson Rd
Flushing, MI 48433
Phone (810) 407-7989

4190 24th Ave
Ste 203
Fort Gratiot, MI 48059
Phone (810) 989-7490

700 S Main St
Ste 101B
Lapeer, MI 48446
Phone (810) 720-1200

1222 10th Ave
Port Huron, MI 48060
Phone (810) 985-9681

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1629549159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46960 VAN DYKE AVE # 8144",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483174378",
            "telephone_number": "586-726-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46960 VAN DYKE AVE # 8144",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483174378",
            "telephone_number": "586-726-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOAS",
        "first_name": "TAMARA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-10",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3016157",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202104987RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704267084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.