Theresa Pankey, RN.380123

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN.380123 Issued in OH

Practice address

2400 Miami Valley Dr
Centerville, OH 45459-4774

Phone

(937) 765-0558

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1659969475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 ROXBURY DR",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453854928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MIAMI VALLEY DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594774",
            "telephone_number": "937-765-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKEY",
        "first_name": "THERESA",
        "credential": "RN.380123",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.380123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Palastro
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• Gary D Palmer, MD
• Gary John Palmer, M.D.
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• Amy Marie Park, DO
• Lloyd Hoehle Parker, DO
• Marie Bernadine Parks

• All providers in Centerville, OH
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.