MRS. TAMMERA L PARK (P.A.-C) – Physician Assistant, NPI 1598853129
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,166 PHYSICIAN ASSISTANT in CO
Provider Addresses for MRS. TAMMERA L PARK (P.A.-C)
1690 Meade St
Denver, CO 802041552
Phone: (970) 439-2313
Type: Location
PO Box 479
Erie, CO 805160479
Phone: (704) 637-8040
Type: Location
1641 S US HIGHWAY 231
CRAWFORDSVILLE, IN 479339421
Phone: (765) 307-7146
Fax: (833) 464-2510
Type: Location
PO BOX 896199
CHARLOTTE, NC 282896199
Phone: (833) 936-1364
Fax: (605) 942-7505
Type: Mailing
101 WILKESBORO ST STE B
MOCKSVILLE, NC 270282321
Phone: (336) 753-0800
Fax: (336) 753-0805
Type: Location
4196 HIGHWAY 62 412 STE A
HARDY, AR 725428002
Phone:
Type: Mailing
7004, Smith Corners Boulevard, Northlake, Charlotte, Mecklenburg County, North Carolina, 28269, United States
STE A
CHARLOTTE, NC 282693827
Phone: (704) 688-9650
Fax: (704) 237-3077
Type: Mailing
628, West Innes Street, Salisbury, Rowan County, North Carolina, 28144, United States
SALISBURY, NC 281444143
Phone: (704) 637-8040
Fax: (704) 237-3077
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-12-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051001000036 | I | Physician Assistant | CO | TBD |
| I20150707001449 | I | Physician Assistant | NC | TBD |
| I20241231002958 | I | Physician Assistant | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 80204)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | TN | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| Physician Assistant | TN | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| Physician Assistant | KY | |
| Nurse Practitioner | TX |
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