Individual provider Active NPI

Tanya Jean Pike, ARNP

  • Family Nurse Practitioner
  • Madison, AL
National Provider Identifier
1780980615
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CRNP1-194303 Issued in AL
Practice address
400 Sun Temple Dr.
Madison, AL 35758
Phone
(256) 774-5524
NPI assigned
Feb 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CRNP1-194303 AL Primary

Addresses

Primary practice location

400 Sun Temple Dr.
Madison, AL 35758

Mailing address

400 Sun Temple Dr
Madison, AL 35758-5924
Phone (256) 774-5524

Other identifiers 2

IdentifierTypeStateIssuer
Y07J1OtherFLBCBS
003418700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110518000374 FL Practitioner - Nurse Practitioner 3779769286 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CRNP1-194303ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Primary Care LLC CurrentSince Jun 11, 2023 Accepting new patients

Locations

400 Sun Temple Dr
Madison, AL 35758
Phone (256) 774-5524

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12216/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tpike719371@direct.shands.ufl.edu

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": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1780980615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585924",
            "telephone_number": "256-774-5524",
            "fax_number": "256-774-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUN TEMPLE DR.",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "35758",
            "telephone_number": "256-774-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKE",
        "first_name": "TANYA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-10",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "CRNP1-194303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y07J1",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003418700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.