Active NPI
Theresa A Mere, SNF
- Pediatric Skilled Nursing Facility
- Aurora, CO
National Provider Identifier
1134640998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Skilled Nursing Facility
- Practice address
- 2670 S Abilene St
Aurora, CO 80014-2336 - Phone
- (303) 695-8100
- NPI assigned
- Jul 3, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Alzheimer Center (Dementia Center) | 311500000X | NH6609 | OK | |
| Custodial Care Facility | 311Z00000X | NH6603-6603 | OK | |
| Pediatric Skilled Nursing Facility | 3140N1450X | Primary |
Addresses
Primary practice location
2670 S Abilene St
Aurora, CO 80014-2336
Mailing address
1 Village Dr Ste 400
Abilene, TX 79606-8232
Phone (325) 691-5519
Other practice location 1
2800 Hickory St
Claremore, OK 74017-1086
Phone (918) 341-4365
Other practice location 2
2700 Hickory St
Claremore, OK 74017-1214
Phone (918) 283-4949
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457786303 | Medicaid | OK | |
| 1184059982 | Medicaid | OK | |
| 1578832226 | Medicaid | CO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| NH6609 | OK | MD | Alzheimer Center (Dementia Center) |
| NH6603-6603 | OK | MD | Custodial Care Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1134640998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 VILLAGE DR STE 400",
"city": "ABILENE",
"state": "TX",
"postal_code": "796068232",
"telephone_number": "325-691-5519",
"fax_number": "325-698-4582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2670 S ABILENE ST",
"city": "AURORA",
"state": "CO",
"postal_code": "800142336",
"telephone_number": "303-695-8100"
}
],
"practiceLocations": [
{
"address_1": "2800 Hickory St",
"address_purpose": "LOCATION",
"city": "Claremore",
"state": "OK",
"postal_code": "740171086",
"country_code": "US",
"telephone_number": "918-341-4365",
"fax_number": "918-341-7218",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2700 Hickory St",
"address_purpose": "LOCATION",
"city": "Claremore",
"state": "OK",
"postal_code": "740171214",
"country_code": "US",
"telephone_number": "918-283-4949",
"fax_number": "918-283-4508",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MERE",
"first_name": "THERESA",
"middle_name": "A",
"credential": "SNF",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-03",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "311500000X",
"taxonomy_group": "",
"desc": "Alzheimer Center (Dementia Center)",
"state": "OK",
"license": "NH6609",
"primary": false
},
{
"code": "311Z00000X",
"taxonomy_group": "",
"desc": "Custodial Care Facility",
"state": "OK",
"license": "NH6603-6603",
"primary": false
},
{
"code": "3140N1450X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457786303",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1184059982",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1578832226",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.