Thera T Radney, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704282153 Issued in MI

Practice address

20720 Plymouth Rd
Detroit, MI 48228-1275

Phone

(313) 493-4330

Fax

(313) 493-4419

NPI assigned

Jan 17, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Thera Terres Simmons Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

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.

• Commerce Sports and Spine PLLC

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  • NPI 1720629157
  Medicare reassignment NPD
• Park Family Health Care, P.C.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1437161437
  Medicare reassignment NPD

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1396281234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28212 FRANKLIN RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341659",
            "telephone_number": "248-356-5555",
            "fax_number": "248-356-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20720 PLYMOUTH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482281275",
            "telephone_number": "313-493-4330",
            "fax_number": "313-493-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADNEY",
        "first_name": "THERA",
        "middle_name": "T",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704282153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERA",
            "last_name": "SIMMONS",
            "middle_name": "TERRES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Crystal Radford, LCSW
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• Rachel N Radjewski, LSW
• Codrut Silviu Ioan Radoiu, MD
• Nahid Raee
• Rafa Therapies Inc
• Abdul Rafay, M.D.
• Samantha Raffee, MD

• Family Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.