Individual provider Active NPI

Teresa Trinidad Calderon, RN

  • Registered Nurse
  • Lakeland, FL
National Provider Identifier
1922352004
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9501003 Issued in FL
Practice address
715 N Lake Ave
Lakeland, FL 33801
Phone
(863) 519-0575
NPI assigned
Oct 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 006586 PR
Registered Nurse 163W00000X RN9501003 FL Primary

Addresses

Primary practice location

715 N Lake Ave
Lakeland, FL 33801

Mailing address

PO Box 1559
Bartow, FL 33831-1559
Phone (863) 519-0575

Other practice location 1

55 Calle Del Carmen W
Fajardo, PR 00738-4717
Phone (787) 860-3558

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9501003FLMDRegistered Nurse
006586PRMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Continuum Mental Care Corp PastSince Jun 16, 2006 Accepting new patients
Continuum Mental Care Corp 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1922352004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338311559",
            "telephone_number": "863-519-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N LAKE AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33801",
            "telephone_number": "863-519-0575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Calle Del Carmen W",
            "address_purpose": "LOCATION",
            "city": "Fajardo",
            "state": "PR",
            "postal_code": "007384717",
            "country_code": "US",
            "telephone_number": "787-860-3558",
            "fax_number": "787-860-3330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRINIDAD CALDERON",
        "first_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-29",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "006586",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9501003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.