Active NPI
Teresa A. Becker, NP
- Neonatal Nurse Practitioner
- Johnson City, TN
National Provider Identifier
1144287616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 52750
- Practice address
- 325 N. State of Franklin Road, Ground Floor
Johnson City, TN 37604-6062 - Phone
- (423) 439-7320
- Fax
- (423) 439-7343
- NPI assigned
- Apr 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 52750 | TN | Primary |
Addresses
Primary practice location
325 N. State of Franklin Road, Ground Floor
Johnson City, TN 37604-6062
Mailing address
PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 433-6000
Other practice location 1
400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6671
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3714474 | Other | TN | GROUP MEDICARE PIN |
| Q013069 | Medicaid | TN |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52750 | TN | MD | Neonatal Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1144287616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 699",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "376840699",
"telephone_number": "423-433-6000",
"fax_number": "423-433-6140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 N. STATE OF FRANKLIN ROAD, GROUND FLOOR",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046062",
"telephone_number": "423-439-7320",
"fax_number": "423-439-7343"
}
],
"practiceLocations": [
{
"address_1": "400 N State Of Franklin Rd",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376046035",
"country_code": "US",
"telephone_number": "423-431-6671",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BECKER",
"first_name": "TERESA",
"middle_name": "A.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-28",
"last_updated": "2024-01-16",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "TN",
"license": "52750",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE PIN",
"identifier": "3714474",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q013069",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.