MELINDA K PEMBERTON (NPI# 1598080160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598080160 |
| Entity Type | Individual |
| Full Name | MELINDA K PEMBERTON |
| Credential | FNP-BC |
| Practice Address |
208 Haley Rd Johnson City TX 78636-4617 |
| Mailing Address |
Po Box 844658 Dallas TX 75284-4658 |
| Practice Telephone | 8308684033 |
| Mailing Telephone | 2547248800 |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2020-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP143639 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200641200A | 05 | |
| MO | RR MEDICARE | P00847174 | 01 |
| MO | 1598080160 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 802 N Riverside Rd Ste 200, Saint Joseph, MO 645072553 | 8162717979 | 8162717971 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508478140 | Melinda Pemberton | Massage Therapist | 2518 Lake Dr, Loveland, CO 80538-3135 | 2020-08-17 |
| Street Address |
208 HALEY RD |
| City | JOHNSON CITY |
| State | TX |
| Zip Code | 78636-4617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093787400 | John Phillip Frasure | Physician Assistant | 208 Haley Rd, Johnson City, TX 78636-4617 | 2006-02-02 |
| 1518528009 | Scott & White Hospital - Marble Falls | Clinic/Center | 208 Haley Rd, Johnson City, TX 78636-4617 | 2019-06-25 |
| 1639511207 | Scott & White Hospital - Marble Falls | Clinic/Center | 208 Haley Rd, Johnson City, TX 78636 | 2013-07-24 |
| 1154475150 | David Allan White | Dentist | 208 Haley Rd, Johnson City, TX 78636-0421 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528541141 | Berg & Florio Od Pa Johnson City | Optometrist | 213 S Highway 281, Suite A, Johnson City, TX 78636 | 2018-09-10 |
| 1801026638 | Txex Med LLC | Pharmacy | 405 Hwy 281 South, Johnson City, TX 78636 | 2009-07-14 |
| 1518901149 | Medical Pumps & Supplies, Inc | Durable Medical Equipment & Medical Supplies | 878 Ranch Road 2766, Johnson City, TX 78636 | 2006-06-15 |
| 1164649802 | Mary Kathryn Hagemeier | Dentist | 400 East Main Street, Johnson City, TX 78636 | 2007-04-20 |
| 1023086063 | North Blanco County Emergency Medical Services, Inc. | Ambulance | 105 Bill Watson Drive, Johnson City, TX 78636-0557 | 2006-03-08 |
| 1578763900 | Mary Elizabeth Eilers | Nurse Practitioner | 1100 Lindig Ln, Johnson City, TX 78636-4489 | 2007-07-24 |
| 1013971548 | Paul Jay Mckee | Anesthesiology | 780 Ranch Road 2721, Johnson City, TX 78636-4589 | 2006-04-13 |
| 1558984278 | Slp Johnson City LLC | Skilled Nursing Facility | 206 Haley Rd, Johnson City, TX 78636-4617 | 2020-05-28 |
| 1447860192 | Kasey Smith | Counselor | 2349 Ranch Road 1323, Johnson City, TX 78636-4787 | 2020-08-07 |
| 1326024464 | Bruce A. Bottcher | Chiropractor | 405 S Us Highway 281, Suite 101-c, Johnson City, TX 78636-4950 | 2005-12-20 |
| Find all providers in zip 78636 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063025724 | Victoria Elizabeth Mcmanus | Nurse Practitioner | 365 Harry L Dr Ste 110, Johnson City, NY 13790-1471 | 2020-08-24 |
| 1649880139 | Amanda Danielle Ledford | Nurse Practitioner | 3 Enfield Ct, Johnson City, TN 37604-9101 | 2020-08-09 |
| 1861000135 | Deborah L Johnson | Nurse Practitioner | 2 Mcgregor Pl, Johnson City, TN 37604-1454 | 2020-07-22 |
| 1255978417 | William Mcguire | Nurse Practitioner | 176 Willocks Rd, Johnson City, TN 37601-6274 | 2019-12-06 |
| 1881248664 | Caiti Riden | Nurse Practitioner | 316 Marketplace Dr Ste 10, Johnson City, TN 37604-2595 | 2019-07-30 |
| 1699330282 | Courtney S Willis | Nurse Practitioner | 2203 N Greenwood Dr, Johnson City, TN 37604-7030 | 2019-05-08 |
| 1861955452 | Cindy Canter | Nurse Practitioner | 3552 Greenwood Dr, Johnson City, TN 37604-2834 | 2019-04-10 |
| 1366908980 | Holly Anne Parvin | Nurse Practitioner | 3209 W Walnut St, Johnson City, TN 37604-5949 | 2019-02-19 |
| 1891261376 | Lindsey Toney | Nurse Practitioner | 980 Smalling Rd, Johnson City, TN 37601-8208 | 2018-10-22 |
| 1821572868 | Karyn Kimberly Bruton | Nurse Practitioner | 1723 N Roan St, Johnson City, TN 37601-3949 | 2018-09-15 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 78636 |
Please comment or provide details below to improve the information on MELINDA K PEMBERTON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.