Individual provider Active NPI

Pamela Trantham, FNP

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1669795399
Registry record updated Nov 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
14829 Issued in TN
Practice address
303 Med Tech Pkwy
Suite 100
Johnson City, TN 37604-2391
Phone
(423) 282-5611
Fax
(423) 282-5712
NPI assigned
Mar 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 14829 TN Primary

Addresses

Primary practice location

303 Med Tech Pkwy
Suite 100
Johnson City, TN 37604-2391

Mailing address

303 Med Tech Pkwy
Suite 100
Johnson City, TN 37604-2391
Phone (423) 282-5611

Other identifiers 1

IdentifierTypeStateIssuer
1521554MedicaidTN

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
I20100820000749 TN Practitioner - Nurse Practitioner 4981738382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians
Champion Physical Therapy LLC HallsGroup PAC ID 1355416306, shared by 4 NPIs, 277 clinicians

Practice addresses (Care Compare)

121 Boone Ridge Dr
Suite 1002
Johnson City, TN 37615-4993

313 Princeton Rd
Suite 3
Johnson City, TN 37601-2000
Phone (423) 282-5435

420 Railroad St
Elizabethton, TN 37643-2504
Phone (423) 297-1813

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14829TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC CurrentSince Mar 21, 2010 Accepting new patients
State of Franklin Healthcare Associates PLLC PastSince Aug 18, 2019 Accepting new patients

Locations

215 E Springbrook Dr
Johnson City, TN 37601
Phone (423) 530-7900

303 Med Tech Pkwy
Ste 100
Johnson City, TN 37604
Phone (423) 282-5611

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

5 Worth Cir
Ste 4
Johnson City, TN 37601
Phone (423) 282-4819

Interoperability endpoints

  • Direct secure messaging: pamelatrantham@sofha.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511049600000",
    "number": "1669795399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MED TECH PKWY",
            "address_2": "SUITE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042391",
            "telephone_number": "423-282-5611",
            "fax_number": "423-282-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MED TECH PKWY",
            "address_2": "SUITE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042391",
            "telephone_number": "423-282-5611",
            "fax_number": "423-282-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRANTHAM",
        "first_name": "PAMELA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2017-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "14829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1521554",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.