Individual provider Active NPI

Teresa Wolanski

  • Pediatric Nurse Practitioner
  • Denver, CO
National Provider Identifier
1154705135
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN.0993020-NP Issued in CO
Practice address
2055 N High St
Denver, CO 80205
Phone
(303) 301-9019
NPI assigned
Jul 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 041385993 IL
Pediatric Nurse Practitioner 363LP0200X APN.0993020-NP CO Primary

Addresses

Primary practice location

2055 N High St
Denver, CO 80205

Mailing address

2763 Dharma Ave
Broomfield, CO 80020-5480
Phone (708) 745-0172

Other practice location 1

5027 Briartree Ln
Unit 213
Burbank, IL 60459-3003
Phone (708) 745-0172

Other practice location 2

2055 N High St
Denver, CO 80205
Phone (303) 301-9019

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

LicenseStateTypeSpecialty
APN.0993020-NPCOMDPediatric Nurse Practitioner
041385993ILMDPediatric Nurse Practitioner

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAGECD/Endpoint/BAGECD

NPI Registry JSON

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

{
    "created_epoch": "1437264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1154705135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2763 DHARMA AVE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800205480",
            "telephone_number": "708-745-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N HIGH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80205",
            "telephone_number": "303-301-9019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5027 Briartree Ln",
            "address_2": "Unit 213",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "IL",
            "postal_code": "604593003",
            "country_code": "US",
            "telephone_number": "708-745-0172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2055 N High St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "80205",
            "country_code": "US",
            "telephone_number": "303-301-9019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLANSKI",
        "first_name": "TERESA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-19",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "041385993",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0993020-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.