Arennette Tysha Anthony, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5004488 Issued in NC

Practice address

508 Fulton St
Durham, NC 27705

Phone

(919) 383-6107

NPI assigned

Sep 24, 2009

Last updated

Aug 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, NM, VA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivy Medical Group PLLCGroup PAC ID 4981097797, 120 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ivy Medical Group PLLC

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1700558798

  NC, VA

  Medicare reassignment Care Compare group
• Daniel Funsch Jr, M.D., P.C.

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1316784580

  NM

  Medicare reassignment NPD
• Dr Medical Services PC

  • Multi-Specialty Clinic/Center
  • New York, NY
  • NPI 1053012401

  NM

  Medicare reassignment NPD
• Dr Rebman BH LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • New York, NY
  • NPI 1114894540

  NC

  Medicare reassignment NPD
• Dr Rebman Medical PA

  • Family Medicine Physician
  • Miami, FL
  • NPI 1669276689

  NC

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1609100528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-383-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27705",
            "telephone_number": "919-383-6107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 Wolf Pack Way",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274068259",
            "country_code": "US",
            "telephone_number": "336-558-4574",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1593 Yanceyville St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274056950",
            "country_code": "US",
            "telephone_number": "336-230-0402 x205",
            "fax_number": "336-230-1761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "ARENNETTE",
        "middle_name": "TYSHA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "197580",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tawfiq Ansari, MD
• Victor Dean Anselmo, DPT
• Annette Kesewah Ansong, MD
• Danielle G Anspach, CNM
• Anthony P. Brown, Jr., DDS, PLLC (New Leaf Pediatric Dentistry)
• Bonnye R Anthony, DDS
• Coyonna Lakia Anthony
• Devon Cordell Anthony
• Kashawnna Anthony
• Kelly K Anthony, PHD

• Family Nurse Practitioner in Durham, NC
• Providers in Durham, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.