Individual provider Active NPI

Teresa Jeter Tollison, RN

  • Registered Nurse
  • Greensboro, NC
National Provider Identifier
1306966718
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
120572 Issued in NC
Practice address
1203 Maple St
Greensboro, NC 27405-6910
Phone
(336) 641-7777
Fax
(336) 641-6971
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 120572 NC Primary

Addresses

Primary practice location

1203 Maple St
Greensboro, NC 27405-6910

Mailing address

1602 Northbay Dr
Browns Summit, NC 27214-9679
Phone (336) 641-3087

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
120572NCMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306966718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 NORTHBAY DR",
            "city": "BROWNS SUMMIT",
            "state": "NC",
            "postal_code": "272149679",
            "telephone_number": "336-641-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 MAPLE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056910",
            "telephone_number": "336-641-7777",
            "fax_number": "336-641-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLISON",
        "first_name": "TERESA",
        "middle_name": "JETER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "120572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • 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.