Individual provider Active NPI

Theresa A Prescott, D.O.

  • Neurology Physician
  • Vero Beach, FL
National Provider Identifier
1457404576
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OS12864 Issued in FL
Practice address
333 17TH St Ste Q
Vero Beach, FL 32960-5686
Phone
(772) 213-8881
NPI assigned
Jan 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X OS 009024 L PA
Child & Adolescent Psychiatry Physician 2084P0804X 25MB07287700 NJ
Child & Adolescent Psychiatry Physician 2084P0804X OS12864 FL
Neurology Physician 2084N0400X OS12864 FL Primary

Addresses

Primary practice location

333 17TH St Ste Q
Vero Beach, FL 32960-5686

Mailing address

333 17TH St Ste Q
Vero Beach, FL 32960-5686
Phone (772) 213-8881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160407001408 FL Practitioner - Psychiatry 6507164530 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS12864FLMDNeurology Physician
25MB07287700NJMDChild & Adolescent Psychiatry Physician
OS 009024 LPAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Jun 4, 2018 Accepting new patients
Vero Beach Recovery Center LLC Current Accepting new patients
Indian River Health Services Inc CurrentSince Jan 11, 2016 Accepting new patients
Vero Beach Recovery Center LLC Current Accepting new patients
Indian River Health Services Inc CurrentSince Jan 11, 2016 Accepting new patients
MCR Health, Inc. CurrentSince Jun 4, 2018 Accepting new patients

Locations

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

333 17th St
Ste M
Vero Beach, FL 32960
Phone (772) 584-3083

1000 36th St
Ste 5105
Vero Beach, FL 32960

Organizations & group practices 6

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": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1457404576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 17TH ST STE Q",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605686",
            "telephone_number": "772-213-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 17TH ST STE Q",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605686",
            "telephone_number": "772-213-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "THERESA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-20",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "OS 009024 L",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MB07287700",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "OS12864",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "OS12864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.