Integrative Therapies for Cancer & Chronic Disease Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP548701 Issued in ME

Legal business name

INTEGRATIVE THERAPIES FOR CANCER & CHRONIC DISEASE INC

Practice address

222 Auburn St Ste 103
Portland, ME 04103-6005

Phone

(207) 699-3838

NPI assigned

Jun 23, 2013

Last updated

May 22, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Colleen Tetzlaff, DNPNPI 1710083233

Title

Owner

Phone

(207) 699-3838

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Colleen Tetzlaff, FNP

  • Family Nurse Practitioner
  • Portland, ME
  • NPI 1710083233
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1371945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1063851046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 AUBURN ST STE 103",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036005",
            "telephone_number": "207-699-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 AUBURN ST STE 103",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036005",
            "telephone_number": "207-699-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE THERAPIES FOR CANCER & CHRONIC DISEASE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-23",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "TETZLAFF",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-699-3838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "NP548701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432379199",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lowell F. Inhorn, M.D.
• Madeline Inlow
• Inspire Health Services LLC
• Mark J Integlia, M.D.
• Integrated Behavioral Healthcare
• Interbloom Therapy Center
• Intermed, PA
• Intermed, PA (InterMed Ambulatory Surgery Center)
• Earl Kenneth Ireland Jr., EDD
• Kate Ireland, LCPC

• Family Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.