Pamela J. Costello, MD, PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

PAMELA J. COSTELLO, MD, PC

Practice address

3915 Bristol Hwy Ste 103
Johnson City, TN 37601-1400

Phone

(423) 461-0073

Fax

(423) 461-0076

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Pamela J Costello, MDNPI 1457365876

Title

Ceo

Phone

(423) 461-0073

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pamela J Costello, MD

  • Neurology Physician
  • Johnson City, TN
  • NPI 1457365876
  Medicare reassignment Authorized official
• Thomas Joseph Whalen III, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Albuquerque, NM
  • NPI 1134120645
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1942310149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 BRISTOL HWY STE 103",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011400",
            "telephone_number": "423-461-0073",
            "fax_number": "423-461-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 BRISTOL HWY STE 103",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011400",
            "telephone_number": "423-461-0073",
            "fax_number": "423-461-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMELA J. COSTELLO, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-461-0073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q05797A",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony J Palazzo, MD
• Melissa S Palazzo, M.D.
• Casey Jordan Palmer, RN
• Helen H Palmer, APRN ANP
• Rebecca Kay Marie Palmer, LPN
• Li Pang, MD
• Stephanie Panoncillo, AUD
• Leslie Weylon Panus, M.D.
• Salvatore Paolillo, M.D.
• Konstantinos Papas, MD

• Neurology Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Neurology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.