Amy Rachelle A Teleron-Khorshad, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35126775 Issued in OH

Practice address

10 Woodlake TRL Ste C
Mount Vernon, OH 43050-9573

Phone

(740) 392-7337

Fax

(740) 392-7333

NPI assigned

May 24, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amy Rachelle Abenoja Teleron Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Children'S Community Practices, LLC

  • Pediatrics Physician
  • Mansfield, OH
  • NPI 1386031896
  Medicare reassignment NPD
• Nationwide Children'S Hospital

  • Dental Clinic/Center
  • Columbus, OH
  • NPI 1407013964
  NPD (past)

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1184943680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WOODLAKE TRL STE C",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509573",
            "telephone_number": "740-392-7337",
            "fax_number": "740-392-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAKE TRL STE C",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509573",
            "telephone_number": "740-392-7337",
            "fax_number": "740-392-7333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 N Clayton St Ste A",
            "address_purpose": "LOCATION",
            "city": "Centerburg",
            "state": "OH",
            "postal_code": "430117059",
            "country_code": "US",
            "telephone_number": "740-625-5326",
            "fax_number": "740-625-5965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 W Cherry St",
            "address_purpose": "LOCATION",
            "city": "Sunbury",
            "state": "OH",
            "postal_code": "430748011",
            "country_code": "US",
            "telephone_number": "740-625-5326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELERON-KHORSHAD",
        "first_name": "AMY RACHELLE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-24",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35126775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135977",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amyrachelle.teleronkhorshadmd.d1.p26@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "10 Woodlake Trl Ste C",
            "city": "Mount Vernon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430509573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMY RACHELLE",
            "last_name": "TELERON",
            "middle_name": "ABENOJA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cova Michelle Talbott, L.P.N.
• Kamal Reza Talukder, MD
• Tandem Health Care of Mt. Vernon, Inc.
• Anna J Taylor
• Jeffrey A Taylor
• Dianna Temple, OTD, OTR/L
• Alix Junior Tercius, M.D.
• Catherine Ann Terry, LSW
• Samuel Joseph Tharp
• Sheri Lee Tharp, NP-C

• Pediatrics Physician in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.