Individual provider Active NPI

Teresa Marie Dobrzykowski, ANP

  • Adult Health Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1013157809
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71001089A Issued in IN
Practice address
316 Indian Ridge Blvd
Mishawaka, IN 46545-9034
Phone
(800) 635-5516
NPI assigned
Mar 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71001089A IN Primary

Addresses

Primary practice location

316 Indian Ridge Blvd
Mishawaka, IN 46545-9034

Mailing address

3355 Douglas Rd
Suite 300
South Bend, IN 46635-1781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71001089AINMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1013157809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS RD",
            "address_2": "SUITE 300",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 INDIAN RIDGE BLVD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465459034",
            "telephone_number": "800-635-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBRZYKOWSKI",
        "first_name": "TERESA",
        "middle_name": "MARIE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71001089A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.