Individual provider Active NPI

Theresa L Tomlinson, CRNP

  • Adult Health Nurse Practitioner
  • York, PA
National Provider Identifier
1649523408
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP012446 Issued in PA
Practice address
924 Colonial Ave
Suite B
York, PA 17403-3450
Phone
(717) 851-7315
Fax
(717) 843-6682
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP012446 PA Primary

Addresses

Primary practice location

924 Colonial Ave
Suite B
York, PA 17403-3450

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-7315

Other identifiers 2

IdentifierTypeStateIssuer
1617427OtherPAGATEWAY MEDICARE ASSURED
2793595OtherPAHIGHMARK BLUE SHIELD FREEDOM BLUE

Other names 1

  • Theresa L Kohlbus Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130130000136 PA Practitioner - Nurse Practitioner 6204080187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

2350 Freedom Way
Suite 150
York, PA 17402-8200
Phone (717) 851-7315

Hospital & facility affiliations

  • Wellspan Vna Home Care Home health agency, York, PA, CCN 397004
  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP012446PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Nov 26, 2012 Accepting new patients
Wellspan Medical Group CurrentSince Nov 26, 2012 Accepting new patients
Wellspan Medical Group Current Accepting new patients

Locations

2350 Freedom Way
Ste 150
York, PA 17402
Phone (717) 851-7315

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

924 Colonial Ave
Ste B
York, PA 17403
Phone (717) 843-8623

Interoperability endpoints

  • Direct secure messaging: ttomlinson97039@wellspan.direct-ci.com

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503964800000",
    "number": "1649523408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-7315",
            "fax_number": "717-741-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 COLONIAL AVE",
            "address_2": "SUITE B",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033450",
            "telephone_number": "717-851-7315",
            "fax_number": "717-843-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLINSON",
        "first_name": "THERESA",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2017-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP012446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1617427",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD FREEDOM BLUE",
            "identifier": "2793595",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "KOHLBUS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.