Individual provider Active NPI

Anne M. Teitelman, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1346442704
Registry record updated Apr 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP008785 Issued in PA
Practice address
4159 W Girard Ave
United Community Clinic
Philadelphia, PA 19104-1010
Phone
(215) 477-3100
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP008785 PA Primary
Registered Nurse 163W00000X RN560450 PA

Addresses

Primary practice location

4159 W Girard Ave
United Community Clinic
Philadelphia, PA 19104-1010

Mailing address

418 Curie Blvd.
Philadelphia, PA 19104
Phone (215) 898-1910

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN560450PAMDRegistered Nurse
SP008785PAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460764800000",
    "number": "1346442704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 CURIE BLVD.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-898-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4159 W GIRARD AVE",
            "address_2": "UNITED COMMUNITY CLINIC",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191041010",
            "telephone_number": "215-477-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITELMAN",
        "first_name": "ANNE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2016-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP008785",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN560450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2016; 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.