Theresa Irene Wussow, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP-03307 Issued in NM

Practice address

1100 Central Ave SE
Albuquerque, NM 87106-4930

Phone

(505) 933-2272

NPI assigned

Sep 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twussow108891@direct.phs.org

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.

• La Casa de Buena Salud Inc.

  • Federally Qualified Health Center (FQHC)
  • Portales, NM
  • NPI 1972603165
  Medicare reassignment NPD
• Los Alamos Family Council, Inc.

  • Mental Health Counselor
  • Los Alamos, NM
  • NPI 1255374021
  Medicare reassignment NPD
• La Casa de Buena Salud Inc

  • Federally Qualified Health Center (FQHC)
  • Clovis, NM
  • NPI 1760788137
  NPD

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1831617265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-933-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUSSOW",
        "first_name": "THERESA",
        "middle_name": "IRENE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-03307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Marie Wuensch, DPT
• Natalie Leann Wulf
• Kurt Altik Wulfekuhler, PH.D.
• Aimee Wunsch
• Riana Wurzburger, MD
• WW Healthcare LLC
• Frank Willis Wyant Jr., D.O.
• Renee Wybenga
• Wyco-Care, Aprn, Nursing Corporation
• Laura Wylie

• Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.