Telesa Andrea Reddick, CERTIFIED HAIR LOSS

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

Practice address

1407 22ND Street South
St Pete, FL 33712

Phone

(813) 863-8477

NPI assigned

Jan 20, 2017

Last updated

Jan 20, 2017By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1871030445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2254 21 AV SOUTH",
            "city": "ST PETE",
            "state": "FL",
            "postal_code": "33712",
            "telephone_number": "813-863-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 22ND STREET SOUTH",
            "city": "ST PETE",
            "state": "FL",
            "postal_code": "33712",
            "telephone_number": "813-863-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDICK",
        "first_name": "TELESA",
        "middle_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "CERTIFIED HAIR LOSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenosha Anderson
• James Garnettiii, MSW
• Rachel Goff, M.S.
• Ramon Maisonet, M.A.
• Donald Bruce Morris, M.D., P.A.
• Donna Wilson

• Prosthetics Case Management in St. Pete, FL
• Providers in St. Pete, FL by specialty
• Prosthetics Case Management in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.