Theresa Diane Allen, RN, NNP-BC

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

ALL1-0440-9583 Issued in MO

Practice address

1 Childrens PL Ste 5S15
Saint Louis, MO 63110-1002

Phone

(314) 495-1236

NPI assigned

Jul 25, 2017

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

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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.

• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment NPD
• Memorial Physician Services

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1174877930
  Medicare reassignment
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD
• Siu Physicians & Surgeons, Inc

  • Pediatrics Physician
  • Springfield, IL
  • NPI 1285657379
  NPD (past)

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1215450812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL STE 5S15",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-495-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL STE 5S15",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-495-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "THERESA",
        "middle_name": "DIANE",
        "credential": "RN, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "MO",
            "license": "ALL1-0440-9583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Allen, BSW
• Stephen P. Allen, M.D.
• Stephen R Allen, PT
• Susan Allen, MSPT
• Terry Allen, PT
• Valinda Allen, MD
• Jordan Allensworth, PA
• Allergy and Asthma Consultants, PC
• Allergy Care Specialists Inc
• Allergy, Asthma & Immunology Institute of St. Louis Inc

• Critical Care Neonatal Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Critical Care Neonatal Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; 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.