EDWARD SHANE TRANTHAM FNP-C
NPI 1043780349
Nurse Practitioner - Family in Holbrook, AZ

Q: What is Edward Trantham's NPI number?

The NPI number for Edward Trantham is 1043780349. It was assigned to this individual provider in the NPPES registry on November 29, 2018.

Q: What is Edward Trantham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Edward Trantham was last updated on March 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 29, 2018PECOS EnrolledAccepts Medicare Assignment

2109 NAVAJO BLVD, HOLBROOK, AZ 86025(928) 524-2851 Get Directions Write a Review

NPPES record last updated: March 19, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 19, 2021, Nov 29, 2018 (2 updates tracked since 2018).

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About Edward Shane Trantham Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWARD SHANE TRANTHAM FNP-C (NPI 1043780349) is an individual family provider in Holbrook, Arizona, licensed in Arizona (219546) and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1043780349

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameEDWARD SHANE TRANTHAMCredential: FNP-C

Location Address2109 NAVAJO BLVDHolbrook, AZ 86025-1822

Mailing AddressPo Box 3630Flagstaff, AZ 86003-3630

Phone(928) 524-2851

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateNovember 29, 2018

Last NPPES UpdateMarch 19, 20212 updates tracked since enumeration

NPPES CertifiedMarch 19, 2021

✔ NPI 1043780349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · 219546

2109 NAVAJO BLVD, Holbrook, AZ 86025

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edward Shane Trantham Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860733573

PECOS Enrollment IDI20190408000157

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

24 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$15.26 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

1 supplier11 claims11 services$91.58 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers22 claims24 services$98.83 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORTH COUNTRY HEALTHCARE, INC.

Clinic/Center (Multi-Specialty)