Emma Grace Mashburn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1206649 Issued in OH

Practice address

1809 Campfire Dr
Knoxville, TN 37931-4346

Phone

(866) 309-7449

NPI assigned

Dec 5, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foothill Clinic LLCGroup PAC ID 9931003795, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Medical Center Hospital, Murray, UT, CCN 460010

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/FFC/api/FHIR/R4

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.

• Foothill Clinic, LLC

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1407947005
  Medicare reassignment Care Compare group
• Foothill Clinic, LLC

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1265513964
  NPD

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

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685836800000",
    "number": "1679283386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 CAMPFIRE DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379314346",
            "telephone_number": "224-602-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 CAMPFIRE DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379314346",
            "telephone_number": "866-309-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHBURN",
        "first_name": "EMMA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2023-06-04",
        "certification_date": "2023-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "1206649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew C Mascioli, DO
• Megan E. Mase, D.O.
• Douglas Masengill Jr.
• Deborah Haynes Mashburn, LPN
• Dena Lynn Mashburn, APN
• Angela Masini, PHD
• Joseph Masini
• Angela Renee' Mason-Arnold
• George C Mason, BS
• Jennifer J Mason, APN

• Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.