Individual provider Active NPI

Teresa White, REGISTER NURSE

  • Home Health Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1104065002
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
118471-030 Issued in WI
Practice address
4419 W Spencer PL
Milwaukee, WI 53216-2450
Phone
(414) 871-7038
NPI assigned
Feb 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 118471-030 WI Primary

Addresses

Primary practice location

4419 W Spencer PL
Milwaukee, WI 53216-2450

Mailing address

4419 W Spencer PL
Milwaukee, WI 53216-2450
Phone (414) 871-7038

Other identifiers 1

IdentifierTypeStateIssuer
38331700MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
118471-030WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1104065002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 W SPENCER PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162450",
            "telephone_number": "414-871-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 W SPENCER PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162450",
            "telephone_number": "414-871-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "TERESA",
        "credential": "REGISTER NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-17",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "118471-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38331700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.