Individual provider Active NPI

Tehira Jenee Gilmore

  • Family Nurse Practitioner
  • Sellersville, PA
National Provider Identifier
1669144069
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP024427 Issued in PA
Practice address
700 Lawn Ave
Sellersville, PA 18960-1548
Phone
(267) 300-8689
NPI assigned
Oct 4, 2021
Last updated
Dec 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP024427 PA Primary

Addresses

Primary practice location

700 Lawn Ave
Sellersville, PA 18960-1548

Mailing address

5841 N 12TH St
Philadelphia, PA 19141-4112
Phone (267) 300-8689

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL philadelphia Direct

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
I20220103001712 PA Practitioner - Nurse Practitioner 9931590890 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

1800 E Park Ave
State College, PA 16803-6709
Phone (814) 231-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Sep 16, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients
Internal Medicine Solutions P.C. CurrentSince Nov 11, 2025 Accepting new patients
Geisinger Clinic CurrentSince Sep 16, 2024 Accepting new patients
Fams4099 CurrentSince May 1, 2024 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

4099 Tamiami Trl N
Ste 403
Naples, FL 34103
Phone (239) 455-0459

100 N Academy Ave
Danville, PA 17822

1412 Lansdowne Ave
Darby, PA 19023
Phone (610) 461-6510

2990 Holme Ave
Philadelphia, PA 19136
Phone (215) 335-2100

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1669144069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 N 12TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191414112",
            "telephone_number": "267-300-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LAWN AVE",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189601548",
            "telephone_number": "267-300-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "TEHIRA",
        "middle_name": "JENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP024427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "philadelphia",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5841 N 12th St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191414112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sellersville, PA

Sources for this page

Verify at the official NPI Registry.