Individual provider Active NPI

Theresa Anne Narasimhan, RN, MSN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1033412549
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F306932-1 Issued in NY
Practice address
1431 Riverplace Blvd
Unit 3408
Jacksonville, FL 32207-9028
Phone
(414) 336-4399
NPI assigned
Dec 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209.008804 IL
Adult Health Nurse Practitioner 363LA2200X 9360704 FL
Nurse Practitioner 363L00000X F306932-1 NY Primary

Addresses

Primary practice location

1431 Riverplace Blvd
Unit 3408
Jacksonville, FL 32207-9028

Mailing address

1431 Riverplace Blvd
Unit 3408
Jacksonville, FL 32207-9028
Phone (414) 336-4399

Other names 1

  • Ms. Theresa Anne Konen Former name

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
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
F306932-1NYMDNurse Practitioner
9360704FLMDAdult Health Nurse Practitioner
209.008804ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wound Systems LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1033412549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 RIVERPLACE BLVD",
            "address_2": "UNIT 3408",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079028",
            "telephone_number": "414-336-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 RIVERPLACE BLVD",
            "address_2": "UNIT 3408",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079028",
            "telephone_number": "414-336-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARASIMHAN",
        "first_name": "THERESA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "RN, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.008804",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9360704",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F306932-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "KONEN",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.

Verify at the official NPI Registry.