Rory Tedrick, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

LP-0000121 Issued in DE

Practice address

1601 Kirkwood Hwy
Wilmington Vamc - Emergency Department
Wilmington, DE 19805-4917

Phone

(302) 994-2511

Fax

(302) 633-5342

NPI assigned

Nov 18, 2014

Last updated

Dec 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1427454404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "address_2": "WILMINGTON VAMC - EMERGENCY DEPARTMENT",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917",
            "telephone_number": "302-994-2511",
            "fax_number": "302-633-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDRICK",
        "first_name": "RORY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LP-0000121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.