Individual provider Active NPI

Tynisha Dushun Herder-Duncan, RN

  • Registered Nurse
  • Dresher, PA
National Provider Identifier
1720857485
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN556108 Issued in PA
Practice address
1023 Daniel Dr
Dresher, PA 19025-1125
Phone
(215) 406-7848
NPI assigned
Dec 22, 2023
Last updated
Dec 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Home Administrator 376G00000X PA-NH007914 PA
Registered Nurse 163W00000X RN556108 PA Primary
Health & Wellness Coach 171400000X

Addresses

Primary practice location

1023 Daniel Dr
Dresher, PA 19025-1125

Mailing address

1023 Daniel Dr
Dresher, PA 19025-1125
Phone (215) 237-9486

Other identifiers 1

IdentifierTypeStateIssuer
1041364520-0001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN556108PAMDRegistered Nurse
PA-NH007914PAMDNursing Home Administrator

Practice roles

OrganizationSpecialtyStatusNew patients
T4Transitions LLC CurrentSince Dec 31, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1720857485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 DANIEL DR",
            "city": "DRESHER",
            "state": "PA",
            "postal_code": "190251125",
            "telephone_number": "215-237-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 DANIEL DR",
            "city": "DRESHER",
            "state": "PA",
            "postal_code": "190251125",
            "telephone_number": "215-406-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDER-DUNCAN",
        "first_name": "TYNISHA",
        "middle_name": "DUSHUN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-22",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "PA",
            "license": "PA-NH007914",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN556108",
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041364520-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dresher, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.