Teresa D Ditmer, APRN-BC, CNS

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

09784 Issued in OH

Practice address

2510 Commons Blvd Ste 210
Beavercreek, OH 45431

Phone

(937) 429-0607

Fax

(937) 558-3068

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104918465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 210",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313821",
            "telephone_number": "937-429-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 210",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "45431",
            "telephone_number": "937-429-0607",
            "fax_number": "937-558-3068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_2": "Suite 435",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-4511",
            "fax_number": "937-384-4501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_2": "Suite 435",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-4511",
            "fax_number": "937-384-4501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DITMER",
        "first_name": "TERESA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "09784",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OH",
            "license": "RN221729",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BOARD OF NURSING",
            "identifier": "09784",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Clinical Nurse Specialist in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Adult Health Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.