Katie E Vance, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2351 Issued in TN

Practice address

1123 N Main St
Dyer, TN 38330-1019

Phone

(731) 692-2853

Fax

(731) 692-2367

NPI assigned

Jun 24, 2013

Sex

Female

Sole proprietor

Yes

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.

• TTRN Medical Services PLLC

  • Family Nurse Practitioner
  • Dyer, TN
  • NPI 1114400587

  TN

  Medicare reassignment

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 21, 2023.

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1861831869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 N MAIN ST",
            "city": "DYER",
            "state": "TN",
            "postal_code": "383301019",
            "telephone_number": "731-692-2853",
            "fax_number": "731-692-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 N MAIN ST",
            "city": "DYER",
            "state": "TN",
            "postal_code": "383301019",
            "telephone_number": "731-692-2853",
            "fax_number": "731-692-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Skyline Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013923",
            "country_code": "US",
            "telephone_number": "731-541-3570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2062 Pleasant Plains Ext Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383056008",
            "country_code": "US",
            "telephone_number": "731-664-2273",
            "fax_number": "731-300-7405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANCE",
        "first_name": "KATIE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rha Trenton Mr Inc.
• Rha Trenton Mr Inc.
• Amy Schleifer
• Lisa Marie Siler, SLP-CCC
• TTRN Medical Services PLLC
• Tammie Jean Wade, LMT
• Kelly Michelle Weaver, PHARM. D
• Janna Martenie Willer

• All providers in Dyer, TN
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.