Tamara Threlkeld Pistoria, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS0008614 Issued in FL

Practice address

1033 N Parkway Frontage Rd
Lakeland, FL 33803-0401

Phone

(863) 647-8011

Fax

(863) 647-8029

NPI assigned

Jul 12, 2005

Last updated

Jun 26, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeland Regional Health Systems, Inc.

  • Multi-Specialty Clinic/Center
  • Lakeland, FL
  • NPI 1497748743
  Medicare reassignment NPD
• Lakeland Regional Medical Center, Inc.

  dba Lakeland Regional Medical Center

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1932107158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95004",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338045004",
            "telephone_number": "863-680-7000",
            "fax_number": "863-680-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 N PARKWAY FRONTAGE RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338030401",
            "telephone_number": "863-647-8011",
            "fax_number": "863-647-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISTORIA",
        "first_name": "TAMARA",
        "middle_name": "THRELKELD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS0008614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264246800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly Pinkerton
• Fredrica Lashay Pinkston
• Nydale Isaiah Pinkston, FNP
• Oliveros Pinlac, PT
• Lynsey Luke Pippen, ED.D.
• Lincoln Henry Pitcher III, ARNP
• Mary A Pitt, BCBA
• Victoria Lynne Pittman, CRNA
• Darius Pitts
• Meyah Pitts

• Pediatrics Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.