Individual provider Active NPI

Joyce Ama Addo, MSPAS

  • Medical Physician Assistant
  • Humboldt, TN
National Provider Identifier
1871881920
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PENDING Issued in TN
Practice address
1804 Main Street
Rainbow Pediatric
Humboldt, TN 38343
Phone
(731) 784-7833
Fax
(731) 784-7856
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PENDING TN Primary

Addresses

Primary practice location

1804 Main Street
Rainbow Pediatric
Humboldt, TN 38343

Mailing address

111 Lake Park Dr
Martin, TN 38237-1316
Phone (731) 588-0777

Medicare participation

Medicare enrollment files
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200702000667 TN Practitioner - Physician Assistant 1355764705 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kofi Nuako MD PCGroup PAC ID 0446143374, 4 clinicians

Practice addresses (Care Compare)

1109 E Reelfoot Ave
Union City, TN 38261-5866

1109 E Reelfoot Ave C
Union City, TN 38261-5866
Phone (731) 884-0600

Hospital & facility affiliations

  • Baptist Memorial Hospital Union City Hospital, Union City, TN, CCN 440130
  • Volunteer Community Hospital Hospital, Martin, TN, CCN 440061

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
92.41
Improvement activities
40
Cost
72.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGTNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Cardiovascular Clinic of West Tennessee,P.C. Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1871881920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LAKE PARK DR",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382371316",
            "telephone_number": "731-588-0777",
            "fax_number": "731-588-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 MAIN STREET",
            "address_2": "RAINBOW PEDIATRIC",
            "city": "HUMBOLDT",
            "state": "TN",
            "postal_code": "38343",
            "telephone_number": "731-784-7833",
            "fax_number": "731-784-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDO",
        "first_name": "JOYCE",
        "middle_name": "AMA",
        "name_prefix": "Miss",
        "credential": "MSPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humboldt, TN

Sources for this page

Verify at the official NPI Registry.