Theresa Susi Bohenek, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP010997 Issued in PA

Practice address

210 Lorna Dr
Hatboro, PA 19040-1706

Phone

(215) 441-0865

NPI assigned

Aug 14, 2011

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1313280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313280000000",
    "number": "1659650299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LORNA DR",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190401706",
            "telephone_number": "215-441-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LORNA DR",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190401706",
            "telephone_number": "215-441-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSI BOHENEK",
        "first_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-14",
        "last_updated": "2011-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN226141L",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP010997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Diane Strohmeier, MS
• Stephen Stunder III
• Jennifer Jin-Kyung Suh, M.D.
• Surgical Success Specialists PLLC
• Surgical Success Specialists, PLLC
• Dedeh Swaray, NP
• Lisa Taxin, PA-C
• Catherine Tevald
• The Offices of Heather Goldner Kinsey, LLC
• The Welcome Project PA

• Adult Health Nurse Practitioner in Hatboro, PA
• Providers in Hatboro, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.