Active NPI
Terilea Jennifer Elkins, MPH, CHES
- Health Educator
- Surprise, AZ
National Provider Identifier
1093377491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 31711
- Practice address
- 14719 W Grand Ave
Surprise, AZ 85374-7203 - Phone
- (623) 471-8447
- Fax
- (623) 213-8523
- NPI assigned
- Jul 5, 2019
- 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 |
|---|---|---|---|---|
| Health Educator | 174H00000X | 31711 | AZ | Primary |
Addresses
Primary practice location
14719 W Grand Ave
Surprise, AZ 85374-7203
Mailing address
14719 W Grand Ave
Surprise, AZ 85374-7203
Phone (623) 471-9355
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 262957251 | Medicaid | AZ | |
| 262957251 | Other | AZ | SENIOR HMO PLANS |
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sun Health Services | Current | Accepting new patients | |
| Sun Health Services | Dietitian, Registered | Current | Accepting new patients |
Locations
14719 W Grand Ave
Surprise, AZ 85374
Phone (623) 471-9355
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Surprise, AZ
- NPI 1285070078
-
- Community Health Clinic/Center
- Surprise, AZ
- NPI 1326463779
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1093377491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14719 W GRAND AVE",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853747203",
"telephone_number": "623-471-9355",
"fax_number": "623-213-8523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14719 W GRAND AVE",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853747203",
"telephone_number": "623-471-8447",
"fax_number": "623-213-8523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELKINS",
"first_name": "TERILEA",
"middle_name": "JENNIFER",
"credential": "MPH, CHES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-05",
"last_updated": "2020-11-04",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "AZ",
"license": "31711",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "262957251",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENIOR HMO PLANS",
"identifier": "262957251",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.