Individual provider Active NPI

Teresa Lynn Anderson, RN/CNM

  • Advanced Practice Midwife
  • Tamuning, GU
National Provider Identifier
1982020392
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
NP-0124 Issued in GU
Practice address
472 Chalan San Antonio Pemar Place
C/O: Marianas Physician Group
Tamuning, GU 96913
Phone
(671) 647-1830
NPI assigned
Mar 10, 2014
Last updated
Mar 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X NP-0124 GU Primary
Registered Nurse 163W00000X RE-1861 GU

Addresses

Primary practice location

472 Chalan San Antonio Pemar Place
C/O: Marianas Physician Group
Tamuning, GU 96913

Mailing address

472 Chalan San Antonio Pemar Place
C/O: Marianas Physician Group
Tamuning, GU 96913
Phone (671) 647-1830

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
Certified Nurse Midwife, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RE-1861GUMDRegistered Nurse
NP-0124GUMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1982020392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 CHALAN SAN ANTONIO PEMAR PLACE",
            "address_2": "C/O: MARIANAS PHYSICIAN GROUP",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-647-1830",
            "fax_number": "647-647-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 CHALAN SAN ANTONIO PEMAR PLACE",
            "address_2": "C/O: MARIANAS PHYSICIAN GROUP",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-647-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN/CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GU",
            "license": "NP-0124",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GU",
            "license": "RE-1861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.