Active NPI
Tammy P. Slater, NP
- Nurse Practitioner
- Winston Salem, NC
National Provider Identifier
1740218148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 0050-01740
- Practice address
- 190 Kimel Park Dr Ste 155
Winston Salem, NC 27103-6946 - Phone
- (336) 765-6637
- Fax
- (336) 765-6964
- NPI assigned
- Jun 28, 2006
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0050-01740 | NC | Primary |
Addresses
Primary practice location
190 Kimel Park Dr Ste 155
Winston Salem, NC 27103-6946
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other practice location 1
160 Kimel Forest Dr
Suite #250
Winston Salem, NC 27103-6074
Phone (336) 765-7655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7003894 | Medicaid | NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tslater144865@direct.novanthealth.org |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0050-01740 | NC | MD | Nurse Practitioner |
Interoperability endpoints
- tslater144865@direct.novanthealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1740218148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 KIMEL PARK DR STE 155",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036946",
"telephone_number": "336-765-6637",
"fax_number": "336-765-6964"
}
],
"practiceLocations": [
{
"address_1": "160 Kimel Forest Dr",
"address_2": "Suite #250",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271036074",
"country_code": "US",
"telephone_number": "336-765-7655",
"fax_number": "336-765-7939",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SLATER",
"first_name": "TAMMY",
"middle_name": "P.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2021-06-16",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "0050-01740",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7003894",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tslater144865@direct.novanthealth.org",
"affiliation": "N",
"address_1": "190 Kimel Park Dr Ste 155",
"city": "Winston Salem",
"state": "NC",
"country_code": "US",
"postal_code": "271036946",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.