Theresa Audrey Yogboh, MSN,CRNP,FNP-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

SP020103 Issued in PA

Practice address

8001 State Rd
Philadelphia, PA 19136-2908

Phone

(215) 335-4869

Fax

(215) 335-1205

NPI assigned

Oct 15, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1922640572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7924 OAK HILL DR",
            "city": "CHELTENHAM",
            "state": "PA",
            "postal_code": "190121708",
            "telephone_number": "484-802-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 STATE RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191362908",
            "telephone_number": "215-335-4869",
            "fax_number": "215-335-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOGBOH",
        "first_name": "THERESA",
        "middle_name": "AUDREY",
        "credential": "MSN,CRNP,FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP020103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EclinicalWorks",
            "affiliation": "Y",
            "endpointDescription": "Software system",
            "affiliationName": "Corizon Health",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8001 State Rd",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191362908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.