Takela Naquay Anderson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5004483 Issued in NC

Practice address

4002 Spring Garden St
Ste C
Greensboro, NC 27407-1683

Phone

(336) 553-0793

NPI assigned

Sep 22, 2009

Last updated

Aug 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21909/brand/1/csg/1/fhir/r4
• Direct secure messaging: takela.anderson.1@21909.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premium Wellness and Primary Care

  • Primary Care Nurse Practitioner
  • Greensboro, NC
  • NPI 1336599547
  Medicare reassignment NPD

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1023342144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8108 BROAD RIDGE CT",
            "city": "BROWNS SUMMIT",
            "state": "NC",
            "postal_code": "272149848",
            "telephone_number": "336-253-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 SPRING GARDEN ST",
            "address_2": "STE C",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071683",
            "telephone_number": "336-553-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TAKELA",
        "middle_name": "NAQUAY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-22",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena Diane Anderson, MPAS, PA-C
• Jeanne E. Anderson, PSY.D.
• Joya Anderson, SLP
• Kelly Galvao Anderson
• Mark Edward Anderson, MD
• Teresa Anderson
• Teresa Lynn Anderson, FNP
• Theodore Starbuck Anderson Jr., M.D.
• Moriah Grace Andino
• Jesse Christopher Andreas, L.AC

• Family Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.