Active NPI
Teddric W. Wolff, CRNA
- Anesthesiologist Assistant
- Tavares, FL
National Provider Identifier
1629186762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- ARNP710652
- Practice address
- 1000 Waterman Way
Tavares, FL 32778-5266 - Phone
- (352) 253-3333
- Fax
- (352) 589-3487
- NPI assigned
- Aug 28, 2006
- Last updated
- Dec 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | ARNP710652 | FL | Primary |
Addresses
Primary practice location
1000 Waterman Way
Tavares, FL 32778-5266
Mailing address
PO Box 3130
Ocala, FL 34478-3130
Phone (352) 867-8311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G2794 | Other | FL | BC BS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP710652 | FL | MD | Anesthesiologist Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196985600000",
"number": "1629186762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3130",
"city": "OCALA",
"state": "FL",
"postal_code": "344783130",
"telephone_number": "352-867-8311",
"fax_number": "352-867-1053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 WATERMAN WAY",
"city": "TAVARES",
"state": "FL",
"postal_code": "327785266",
"telephone_number": "352-253-3333",
"fax_number": "352-589-3487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFF",
"first_name": "TEDDRIC",
"middle_name": "W.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-28",
"last_updated": "2007-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "FL",
"license": "ARNP710652",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS",
"identifier": "G2794",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tavares, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.