Individual provider Active NPI

Theodore Tinnell

  • General Practice Registered Nurse
  • Boston, MA
National Provider Identifier
1427626969
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
R245581 Issued in MD
Practice address
1 Boston PL Ste 2600
Boston, MA 02108-4420
Phone
(617) 958-5697
NPI assigned
Jun 11, 2021
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X R245581 MD Primary

Addresses

Primary practice location

1 Boston PL Ste 2600
Boston, MA 02108-4420

Mailing address

130 N Pearl St Apt 605
Denver, CO 80203-4190
Phone (303) 809-1261

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

State licenses

LicenseStateTypeSpecialty
R245581MDMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ampersex.VA PC Current Accepting new patients
Ampersex.VA PC Current Accepting new patients

Locations

1 Boston Pl
Ste 2600
Boston, MA 02108
Phone (617) 817-8640

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1427626969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N PEARL ST APT 605",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802034190",
            "telephone_number": "303-809-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON PL STE 2600",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021084420",
            "telephone_number": "617-958-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINNELL",
        "first_name": "THEODORE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MD",
            "license": "R245581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.