Tera Kay Waldroup, RN, APN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2278241 Issued in MA

Practice address

94 Main St
Hyannis, MA 02601-3146

Phone

(508) 771-9599

Fax

(508) 771-1208

NPI assigned

Feb 16, 2012

Last updated

Dec 30, 2012By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Concho Valley Center for Human AdvancementGroup PAC ID 7719936533, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Concho Valley Center for Human Advancement

  dba MHMR Services for the Concho Valley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Angelo, TX
  • NPI 1164479192

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Concho Valley Center for Human Advancement

  dba MHMR Services for the Concho Valley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Angelo, TX
  • NPI 1801937495

  Psychiatric/Mental Health

  NPD

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

• Shannon Medical Center

  • General Acute Care Hospital
  • San Angelo, TX
  • NPI 1992707228
  Care Compare affiliation

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356825600000",
    "number": "1710250055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 PATRIOT WAY",
            "city": "CENTERVILLE",
            "state": "MA",
            "postal_code": "026321514",
            "telephone_number": "214-718-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 MAIN ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013146",
            "telephone_number": "508-771-9599",
            "fax_number": "508-771-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDROUP",
        "first_name": "TERA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "RN, APN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2278241",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "751298",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Wagner, RN
• Gretchen Lorraine Wahtola, RN
• Leanne J Waksman
• Mark J Walcutt, DC
• Roberta S Walcutt, DC
• Amy Walenga, APRN
• Walgreen Co (Walgreens #17259)
• Walgreen Co (Walgreens #17545)
• Andrew James Wall, MD
• Christopher James Wallace, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Hyannis, MA
• Providers in Hyannis, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.