Individual provider Active NPI

Theresa Latorre-Tegtmeier, NP-C

  • Nurse Practitioner
  • Dover, DE
National Provider Identifier
1215309802
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LG-0000895 Issued in DE
Practice address
530 S State St Ste 107
Dover, DE 19901-3562
Phone
(302) 608-5299
Fax
(302) 608-3885
NPI assigned
Oct 22, 2015
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LG-0000895 DE Primary

Addresses

Primary practice location

530 S State St Ste 107
Dover, DE 19901-3562

Mailing address

640 S State St
Mail Code 3055
Dover, DE 19901-3530
Phone (302) 480-1688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160516002382 DE Practitioner - Nurse Practitioner 6507155488 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, shared by 16 NPIs, 399 clinicians

Practice addresses (Care Compare)

100 Wellness Way
Milford, DE 19963-4364
Phone (302) 480-1688

640 S State St
Bayhlth Kent Campus
Dover, DE 19901-3530
Phone (302) 744-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Sep 1, 2023 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Mar 16, 2016 Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients

Locations

530 S State St
Ste 107
Dover, DE 19901
Phone (302) 608-5299

640 S State St
Dover, DE 19901
Phone (302) 744-4700

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

640 S State St
Rm 300D
Dover, DE 19901

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

18383 Hudson Rd
Ste B
Milton, DE 19968
Phone (302) 725-3499

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1215309802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S STATE ST STE 107",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013562",
            "telephone_number": "302-608-5299",
            "fax_number": "302-608-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATORRE-TEGTMEIER",
        "first_name": "THERESA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-22",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0000895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.