Edward Shane Trantham, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Holbrook, Arizona. He graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice North Country Healthcare Inc and his current practice location is
2109 Navajo Blvd, Holbrook, Arizona. You can reach out to his office (for appointments etc.) via phone at
(928) 524-2851.
Edward Shane Trantham is licensed to practice in Arizona (license number 219546) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1043780349.
Provider's Profile
| Full Name | Edward Shane Trantham |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 2109 Navajo Blvd, Holbrook, Arizona |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Edward Shane Trantham graduated from nursing school in 2018
NPI Data:
- NPI Number: 1043780349
- Provider Enumeration Date: 11/29/2018
- Last Update Date: 03/19/2021
Medicare PECOS Information:
- PECOS PAC ID: 2860733573
- Enrollment ID: I20190408000157
Medical Identifiers
Medical identifiers for Edward Shane Trantham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043780349 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 219546 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| North Country Healthcare Inc | 8820981053 | 62 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Edward Shane Trantham allows following entities to bill medicare on his behalf.
| Entity Name | North Country Healthcare Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073583472
PECOS PAC ID: 8820981053
Enrollment ID: O20040210001107 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Edward Shane Trantham is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Edward Shane Trantham, FNP-C
Po Box 3630,
Flagstaff, AZ 86003-3630
Ph: () - | Edward Shane Trantham, FNP-C
2109 Navajo Blvd,
Holbrook, AZ 86025-1822
Ph: (928) 524-2851 |
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