Individual provider Active NPI

Teresa Nidey, RN

  • Infusion Therapy Registered Nurse
  • Kalamazoo, MI
National Provider Identifier
1235625831
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Registered NurseTaxonomy code 163WI0500X
License
4704314476 Issued in MI
Practice address
6480 Technology Ave Ste a
Kalamazoo, MI 49009-8116
Phone
(269) 250-8000
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered Nurse 163WI0500X 4704314476 MI Primary

Addresses

Primary practice location

6480 Technology Ave Ste a
Kalamazoo, MI 49009-8116

Mailing address

6480 Technology Ave Ste a
Kalamazoo, MI 49009-8116
Phone (269) 250-8000

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704314476MIMDInfusion Therapy Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1235625831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 TECHNOLOGY AVE STE A",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098116",
            "telephone_number": "269-250-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 TECHNOLOGY AVE STE A",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098116",
            "telephone_number": "269-250-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIDEY",
        "first_name": "TERESA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "MI",
            "license": "4704314476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.