Active NPI
Petrea Palmer Tomko, PA-C
- Family Medicine Physician
- Pensacola, FL
National Provider Identifier
1689901894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- PA9105006
- Practice address
- 4601 Spanish TRL
Pensacola, FL 32504-5039 - Phone
- (850) 969-2001
- Fax
- (850) 433-8940
- NPI assigned
- Nov 9, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PA9105006 | FL | Primary |
Addresses
Primary practice location
4601 Spanish TRL
Pensacola, FL 32504-5039
Mailing address
4601 Spanish TRL
Pensacola, FL 32504-5039
Phone (850) 969-2001
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265760000000",
"number": "1689901894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 SPANISH TRL",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325045039",
"telephone_number": "850-969-2001",
"fax_number": "850-433-8940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 SPANISH TRL",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325045039",
"telephone_number": "850-969-2001",
"fax_number": "850-433-8940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMKO",
"first_name": "PETREA",
"middle_name": "PALMER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-09",
"last_updated": "2010-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "PA9105006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.