Teresa Lynne Jodway, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71000447A Issued in IN

Practice address

209 Florence Ave
Granger, IN 46530-8048

Phone

(574) 246-1000

Fax

(574) 246-4000

NPI assigned

Nov 17, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saint Joseph Community Hospital of Mishawaka

  • Multi-Specialty Clinic/Center
  • Mishawaka, IN
  • NPI 1235202573
  NPD (past)
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1780758474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11983 JEFFERSON BLVD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465457817",
            "telephone_number": "574-259-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 FLORENCE AVE",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308048",
            "telephone_number": "574-246-1000",
            "fax_number": "574-246-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JODWAY",
        "first_name": "TERESA",
        "middle_name": "LYNNE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000447A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71000447A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "28103938A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200204520",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "71000447A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherri Temple Isaak, MS, CDE
• Felpur Elumba Jabian, D.P.T.
• Serenity Jackson
• James R Hurst PHD LLC
• Jeremy Kwon & Associates Inc.
• Charisse D Johnson, MD
• Bruce Joray, LCSW
• Jeanette Josol Jumao-As, PT
• Kelsey L Jurgonski, NP
• Katendi Kanema, APRN

• Pediatric Nurse Practitioner in Granger, IN
• Providers in Granger, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.