Individual provider Active NPI

Ann Marie Theresa Storbrauck, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jamison, PA
National Provider Identifier
1417142514
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP018884 Issued in PA
Practice address
2813 Lee Dr
Jamison, PA 18929-1047
Phone
(267) 884-4788
Fax
(215) 798-9726
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP018884 PA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R149292 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209029491 IL
Adult Health Nurse Practitioner 363LA2200X SP009486 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00297900 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 30454 SC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 32914 TN

Addresses

Primary practice location

2813 Lee Dr
Jamison, PA 18929-1047

Mailing address

30 S 15TH St Ste 1550
Philadelphia, PA 19102-4806
Phone (267) 884-4788

Other names 1

  • Miss Ann Marie Theresa Mignona Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161202000574 PA Practitioner - Nurse Practitioner 4880974187 Reassigns benefits to 5 organizations
I20260616000286 SC Practitioner - Nurse Practitioner 4880974187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2261 Market St
San Francisco, CA 94114-1612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP009486PAMDAdult Health Nurse Practitioner
209029491ILMDPsychiatric/Mental Health Nurse Practitioner
R149292MDMDPsychiatric/Mental Health Nurse Practitioner
26NJ00297900NJMDPsychiatric/Mental Health Nurse Practitioner
30454SCMDPsychiatric/Mental Health Nurse Practitioner
32914TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Medical Services, Inc. CurrentSince Oct 13, 2021 Accepting new patients
Alegis Care - Pennsylvania PC CurrentSince Jan 25, 2022 Accepting new patients
Evernorth Care Providers - Delaware PA CurrentSince Mar 6, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Sep 1, 2025 Accepting new patients
Evernorth Care Providers - Delaware PA CurrentSince Mar 6, 2024 Accepting new patients
Joseph Dantonio MD PC CurrentSince Sep 1, 2018 Accepting new patients

Locations

160 Rock Hill Rd
Fl 1
Bala Cynwyd, PA 19004
Phone (610) 667-5460

615 W Main St
Lansdale, PA 19446
Phone (215) 453-1321

1650 Market St
Philadelphia, PA 19103
Phone (215) 514-0760

3000 Park Ln
Pittsburgh, PA 15275

730 Cool Springs Blvd
Ste 500
Franklin, TN 37067

Interoperability endpoints

  • Direct secure messaging: astorbrauck29227@evernorth.direct-ci.com
  • Direct secure messaging: annmarie.storbrauck.p2@direct.alegiscare.nextgenshare.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1417142514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S 15TH ST STE 1550",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024806",
            "telephone_number": "267-884-4788",
            "fax_number": "215-798-9726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 LEE DR",
            "city": "JAMISON",
            "state": "PA",
            "postal_code": "189291047",
            "telephone_number": "267-884-4788",
            "fax_number": "215-798-9726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORBRAUCK",
        "first_name": "ANN MARIE",
        "middle_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP018884",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R149292",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209029491",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP009486",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00297900",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "30454",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "32914",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN MARIE",
            "last_name": "MIGNONA",
            "middle_name": "THERESA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jamison, PA

Sources for this page

Verify at the official NPI Registry.