Individual provider Active NPI

Wayne Paul Tamberelli, PA-C

  • Physician Assistant
  • Nashville, NC
National Provider Identifier
1891829156
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000100379 Issued in NC
Practice address
107 W Nashville Dr Ste a
Nashville, NC 27856-1289
Phone
(252) 822-3583
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000100379 NC
Physician Assistant 363A00000X 000100379 NC Primary

Addresses

Primary practice location

107 W Nashville Dr Ste a
Nashville, NC 27856-1289

Mailing address

107 W Nashville Dr Ste a
Nashville, NC 27856-1289
Phone (252) 822-3583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20080808000675 NC Practitioner - Physician Assistant 3577637552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care and Urgent Care of Nashville, PLLCGroup PAC ID 4880069533, 5 clinicians

Practice addresses (Care Compare)

107 W Nashville Dr
Nashville, NC 27856-1289
Phone (252) 822-3583

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000100379NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Group, Inc. Past Accepting new patients

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.

Hospital & facility affiliations 1

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1891829156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W NASHVILLE DR STE A",
            "city": "NASHVILLE",
            "state": "NC",
            "postal_code": "278561289",
            "telephone_number": "252-822-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W NASHVILLE DR STE A",
            "city": "NASHVILLE",
            "state": "NC",
            "postal_code": "278561289",
            "telephone_number": "252-822-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMBERELLI",
        "first_name": "WAYNE",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "000100379",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "000100379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, NC

Sources for this page

Verify at the official NPI Registry.