Active NPI
Teresa B. Redmond, FNP
- Family Nurse Practitioner
- Meridian, MS
National Provider Identifier
1780682807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R504955
- Practice address
- 1314 19TH Ave
Meridian, MS 39301-4116 - Phone
- (601) 703-4415
- Fax
- (601) 703-4418
- NPI assigned
- Jul 12, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R504955 | MS | Primary |
| Occupational Health Nurse Practitioner | 363LX0106X | R504955 | MS |
Addresses
Primary practice location
1314 19TH Ave
Meridian, MS 39301-4116
Mailing address
PO Box 5183
Meridian, MS 39302-5183
Phone (601) 703-9506
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 730-00516 | Other | BLUE CROSS OF AL | |
| 500003752 | Other | RAILROAD MEDICARE | |
| 00118205 | Medicaid | MS | |
| 891001670 | Medicaid | AL |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R504955 | MS | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267056000000",
"number": "1780682807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5183",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393025183",
"telephone_number": "601-703-9506",
"fax_number": "601-703-3264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 19TH AVE",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393014116",
"telephone_number": "601-703-4415",
"fax_number": "601-703-4418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDMOND",
"first_name": "TERESA",
"middle_name": "B.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-12",
"last_updated": "2010-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R504955",
"primary": true
},
{
"code": "363LX0106X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Occupational Health",
"state": "MS",
"license": "R504955",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF AL",
"identifier": "730-00516",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500003752",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00118205",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891001670",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meridian, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.