Theresa M Benassi-Powles, APN CNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

Practice address

601 James R Thompson Blvd
Building D 2015
East Saint Louis, IL 62201-1129

Phone

(618) 482-6959

Fax

(618) 482-8311

NPI assigned

Feb 8, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Practitioner

State licenses

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215078928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JAMES R THOMPSON BLVD",
            "address_2": "BUILDING D 2015",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622011129",
            "telephone_number": "618-482-6959",
            "fax_number": "618-482-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JAMES R THOMPSON BLVD",
            "address_2": "BUILDING D 2015",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622011129",
            "telephone_number": "618-482-6959",
            "fax_number": "618-482-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENASSI-POWLES",
        "first_name": "THERESA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Marie Avery, NP
• Darrell M. Ballinger, MD
• Christopher Wayne Barry, LMSW, CRADC
• Virginia L Behrhorst, BC APRN
• Jasmin A Bell
• Estelisa Bevely, RN
• Clydie Blackwell, RN
• Board of Trustees of Southern Illinois University (Southern Illinois University Edwardsville)
• Karen D Boide, PTA
• Carolyn M. Booth, PA

• Pediatric Nurse Practitioner in East Saint Louis, IL
• Providers in East Saint Louis, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.