Theresa Setter NP Family Health PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

THERESA SETTER NP FAMILY HEALTH PLLC

Doing business as

Revitalize CNY
Revitalize Dermatology & Aesthetics

Practice address

516 E Genesee St
Fayetteville, NY 13066-1537

Phone

(315) 251-1234

Fax

(315) 251-1144

NPI assigned

Sep 19, 2022

Organization subpart

No

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

Authorized official

Name

Theresa M. Setter, APRN-BC

Title

Ceo

Phone

(315) 251-1234

Specialties & licenses 2

Addresses

Other names 2

• Revitalize CNY Doing business as
• Revitalize Dermatology & Aesthetics Doing business as

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1568184372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E GENESEE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661537",
            "telephone_number": "315-251-1234",
            "fax_number": "315-251-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E GENESEE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661537",
            "telephone_number": "315-251-1234",
            "fax_number": "315-251-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA SETTER NP FAMILY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-19",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "SETTER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "315-251-1234",
        "authorized_official_credential": "APRN-BC"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revitalize CNY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Revitalize Dermatology & Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Syracuse Supply Inc
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• Terra Organic Spa
• Diamond M Thaxton, LPMHC
• Thomas J Krisher, PSYD PC
• David A Thorpe, DC
• Kent Ryan Thorpe, D.C.
• Abigail Tillman, MD
• Tracy Torelli

• Family Nurse Practitioner in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.