Individual provider Active NPI

Pamala Kay Gayheart, LPN

  • Licensed Practical Nurse
  • Newark, OH
National Provider Identifier
1922174846
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN113747 Issued in OH
Practice address
9363 Wilkins Run Rd NE
Newark, OH 43055-8898
Phone
(740) 745-3382
Fax
(740) 745-3382
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN113747 OH Primary

Addresses

Primary practice location

9363 Wilkins Run Rd NE
Newark, OH 43055-8898

Mailing address

9363 Wilkins Run Rd NE
Newark, OH 43055-8898
Phone (740) 745-3382

Other identifiers 1

IdentifierTypeStateIssuer
2610553OtherOHINDEPENDENT PROVIDER

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN113747OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1922174846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9363 WILKINS RUN RD NE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430558898",
            "telephone_number": "740-745-3382",
            "fax_number": "740-745-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9363 WILKINS RUN RD NE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430558898",
            "telephone_number": "740-745-3382",
            "fax_number": "740-745-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYHEART",
        "first_name": "PAMALA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN113747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT PROVIDER",
            "identifier": "2610553",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.