Individual provider Active NPI

Theresa A Ledesma, ARNP

  • Emergency Clinical Nurse Specialist
  • Oelwein, IA
National Provider Identifier
1821196700
Registry record updated Apr 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Clinical Nurse SpecialistTaxonomy code 364SE0003X
License
A080263 Issued in IA
Practice address
201 8TH Ave SE
Oelwein, IA 50662-2447
Phone
(319) 283-6000
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2010

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A080263 IA
Nurse Practitioner 363L00000X A080263 IA
Family Nurse Practitioner 363LF0000X A080263 IA
Emergency Clinical Nurse Specialist 364SE0003X A080263 IA Primary
Community Health Nurse Practitioner 363LC1500X A080263 IA

Addresses

Primary practice location

201 8TH Ave SE
Oelwein, IA 50662-2447

Mailing address

3421 W 9TH St
Waterloo, IA 50702-5401
Phone (319) 272-7303

Other identifiers 1

IdentifierTypeStateIssuer
0074625MedicaidIA

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

LicenseStateTypeSpecialty
A080263IAMDEmergency Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Iowa Mental Health Center PastSince Nov 21, 2008 Accepting new patients
United Community Services, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270425600000",
    "number": "1821196700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-7303",
            "fax_number": "319-272-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 8TH AVE SE",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "506622447",
            "telephone_number": "319-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDESMA",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "A080263",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A080263",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A080263",
            "primary": false
        },
        {
            "code": "364SE0003X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": "IA",
            "license": "A080263",
            "primary": true
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "IA",
            "license": "A080263",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074625",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oelwein, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.

Verify at the official NPI Registry.