Individual provider Active NPI

Theresa Edobor-Whiskey

  • Home Health Registered Nurse
  • Bronx, NY
National Provider Identifier
1104070945
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
638068 Issued in NY
Practice address
3440 Edson Ave
Bronx, NY 10469-2609
Phone
(646) 228-6209
NPI assigned
Nov 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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 638068 NY Primary

Addresses

Primary practice location

3440 Edson Ave
Bronx, NY 10469-2609

Mailing address

3440 Edson Ave
Bronx, NY 10469-2609
Phone (646) 228-6209

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
638068NYMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1104070945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 EDSON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692609",
            "telephone_number": "646-228-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 EDSON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692609",
            "telephone_number": "646-228-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDOBOR-WHISKEY",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "638068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.