Terri Tonisha Van Dorn, NP (ACNP-BC)

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN195252 Issued in GA

Practice address

1901 Honey Creek Commons SE
Conyers, GA 30013-5806

Phone

(678) 413-3752

Fax

(678) 413-3751

NPI assigned

Dec 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Terri Tonisha Moore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Georgia NP House Calls, LLC

  • Home Health Agency
  • Jonesboro, GA
  • NPI 1679156616
  NPD Authorized official

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1124363577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 WINN WAY",
            "address_2": "SUITE A-20",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301712",
            "telephone_number": "404-294-7033",
            "fax_number": "404-296-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 HONEY CREEK COMMONS SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300135806",
            "telephone_number": "678-413-3752",
            "fax_number": "678-413-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DORN",
        "first_name": "TERRI",
        "middle_name": "TONISHA",
        "name_prefix": "Mrs.",
        "credential": "NP (ACNP-BC)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN195252",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN195252",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN195252",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "MOORE",
            "middle_name": "TONISHA",
            "credential": "NP (ACNP-BC)",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Unlimited Quality Care, LLC
• Lacretia Usher
• Ngozi Uwe
• Michelle Uzor
• Pamela Vacaolivo, LMT
• Tedman L. Vance, M.D.
• Subba Reddy Vanga, MD
• Michael Joseph Varnado Jr., PHARMD
• Naytasha C Varner, RBT
• Joy Vason

• Nurse Practitioner in Conyers, GA
• Providers in Conyers, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.