Theresa Antwi

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

105066 Issued in CT

Practice address

1331 Burnside Ave Apt A4
East Hartford, CT 06108-1577

Phone

(240) 408-0736

NPI assigned

Sep 17, 2021

Last updated

Sep 17, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Step Up Care PC LLC

  • Counselor
  • Danielson, CT
  • NPI 1154884740
  Medicare reassignment NPD
• Live Well LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • East Hartford, CT
  • NPI 1093563645
  NPD Authorized official

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1053081398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 BURNSIDE AVE APT A4",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061081577",
            "telephone_number": "240-408-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 BURNSIDE AVE APT A4",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061081577",
            "telephone_number": "240-408-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTWI",
        "first_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "105066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "#",
            "affiliation": "N",
            "address_1": "1331 Burnside Ave Apt A4",
            "city": "East Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061081577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenneth Dow Anderson, CAC, CADC, RSS
• Angelic Visitation LLC
• Antero, Inc
• Raymond J Anton, M.D.
• John Antonio
• Michael Paul Aparo
• Daniella Appiah
• Barbara Arcarese, D.O
• Cassidy Arnold
• Gretchen Venezia Arnold, RDH

• Psychiatric/Mental Health Nurse Practitioner in East Hartford, CT
• Providers in East Hartford, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.