Teresa Marie Ayres, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105366 Issued in FL

Practice address

61 Memorial Medical Pkwy
Suite 2811
Palm Coast, FL 32164-5981

Phone

(386) 586-4752

Fax

(386) 586-4754

NPI assigned

Jul 12, 2011

Last updated

Sep 22, 2011By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Memorial Hospital Flagler Inc

  dba AdventHealth Palm Coast

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  NPD (past)
• Memorial Hospital Flagler Inc.

  dba AdventHealth Medical Group

  • Multi-Specialty Clinic/Center
  • Palm Coast, FL
  • NPI 1558530600
  NPD (past)

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1629366687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 2811",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645981",
            "telephone_number": "386-586-4752",
            "fax_number": "386-586-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 2811",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645981",
            "telephone_number": "386-586-4752",
            "fax_number": "386-586-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYRES",
        "first_name": "TERESA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.