Active NPI
Myra Lynn Teasley, M.D.
- Specialist
- Raleigh, NC
National Provider Identifier
1013977636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 32181
- Practice address
- 4414 Lake Boone TRL
Suite 300
Raleigh, NC 27607-7513 - Phone
- (919) 781-5510
- Fax
- (919) 781-5053
- NPI assigned
- Mar 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 32181 | NC | Primary |
Addresses
Primary practice location
4414 Lake Boone TRL
Suite 300
Raleigh, NC 27607-7513
Mailing address
7628 Rainwater Rd
Raleigh, NC 27615-3745
Phone (919) 781-5510
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32716 | Other | NC | PARTNERS |
| 750598 | Other | NC | UNITED HEALTHCARE |
| 8982346 | Medicaid | NC | |
| 82346 | Other | NC | BC/BS |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32181 | NC | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Carolina OB/GYN | Specialist | Current | Accepting new patients |
Locations
4414 Lake Boone Trl
Ste 300
Raleigh, NC 27607
Phone (919) 781-5510
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Raleigh, NC
- NPI 1457311870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427673600000",
"number": "1013977636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7628 RAINWATER RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153745",
"telephone_number": "919-781-5510",
"fax_number": "919-781-5053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4414 LAKE BOONE TRL",
"address_2": "SUITE 300",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077513",
"telephone_number": "919-781-5510",
"fax_number": "919-781-5053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEASLEY",
"first_name": "MYRA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-27",
"last_updated": "2015-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "32181",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "32716",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "750598",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8982346",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "82346",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.