Individual provider Active NPI

Teresa Louise Donaldson, CRNA

  • Certified Registered Nurse Anesthetist
  • Stockton, CA
National Provider Identifier
1508816232
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA311 Issued in CA
Practice address
1805 N California St
Ste 101
Stockton, CA 95204-6037
Phone
(888) 270-0340
Fax
(888) 270-0331
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN225414 CA
Certified Registered Nurse Anesthetist 367500000X NA311 CA Primary

Addresses

Primary practice location

1805 N California St
Ste 101
Stockton, CA 95204-6037

Mailing address

1805 N California St
Ste 101
Stockton, CA 95204-6037
Phone (888) 270-0340

Other identifiers 1

IdentifierTypeStateIssuer
RN22541410MedicaidCA

Other names 1

  • Teresa Louise Ilardi Other name

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
NA311CAMDCertified Registered Nurse Anesthetist
RN225414CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Creek OB Anesthesia Services, a Professional Nursing Corporatio Nurse Anesthetist, Certified Registered Past Accepting new patients
Soma Anesthesia Medical Group Inc Past Accepting new patients
Twin Cities Surgicenter, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1508816232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST",
            "address_2": "STE 101",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046037",
            "telephone_number": "888-270-0340",
            "fax_number": "888-270-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST",
            "address_2": "STE 101",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046037",
            "telephone_number": "888-270-0340",
            "fax_number": "888-270-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "TERESA",
        "middle_name": "LOUISE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "RN225414",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN22541410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "ILARDI",
            "middle_name": "LOUISE",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.