ANTONIA ROSARIO TETTAMANTI (NPI# 1164480455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164480455 |
| Entity Type | Individual |
| Full Name | ANTONIA ROSARIO TETTAMANTI |
| Practice Address |
2801 Lyndhurst Ave Winston Salem NC 27103-4109 |
| Practice Telephone | 3367689575 |
| Practice Fax Number | 9498628929 |
| Mailing Telephone | 3367689575 |
| Mailing Fax Number | 9498628929 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2015-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 20137 | NC | Allopathic & Osteopathic Physicians |
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
20137 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8982441 | 05 | |
| NC | RAILROAD MEDICARE | P00317035 | 01 |
| NC | UNITED HEALTHCARE | 0109922 | 01 |
| NC | BCBSNC | 82441 | 01 |
| Street Address |
2801 LYNDHURST AVE |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-4109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922323948 | Club Haven Family Practice Pa | Family Medicine | 2801 Lyndhurst Ave, Winston Salem, NC 27103-4109 | 2010-04-01 |
| 1942489695 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 2801 Lyndhurst Ave, Winston Salem, NC 27103-4109 | 2007-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629620398 | Monika Daniela Gonzalez Kroll | Family Medicine | 512 Waughtown St, Winston Salem, NC 27127-2236 | 2019-07-12 |
| 1083899009 | Physicians Home Visits, PC | Family Medicine | 3069 Trenwest Dr, Ste 200, Winston Salem, NC 27103-3211 | 2008-01-09 |
| 1710174636 | Larry Shelton Kilby | Family Medicine | 730 Highland Oaks Dr, Suite 101, Winston Salem, NC 27103 | 2007-09-25 |
| 1306805841 | Enrico E Piva | Family Medicine | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538771795 | Michelle Muhammad | Family Medicine | 1589 Skeet Club Rd Ste 102-218, High Point, NC 27265-8817 | 2020-08-19 |
| 1578171724 | Immuno Professionals Pllc | Family Medicine | 9300 Harris Corners Pkwy Ste 160, Charlotte, NC 28269-3791 | 2020-07-14 |
| 1225549991 | Tawfiq Ansari | Family Medicine | 5 Scarlet Oak Ct, Durham, NC 27712-8971 | 2017-10-20 |
| 1215457924 | J Arthur Dosher Memorial Hospital | Family Medicine | 906 N Howe Street, Southport, NC 28461-2846 | 2017-06-23 |
| 1215342779 | Alexandria Kadolph | Family Medicine | Moses Cone Hospital, 1121 N Church St, Greensboro, NC 27405 | 2014-06-24 |
| 1669715868 | David A Crowe | Family Medicine | West Wilkes Family Medicine, 171 West Wilkes Medical Center Blvd., Ferguson, NC 28624-8925 | 2013-04-05 |
| 1417261736 | Talton Physician Services Pllc | Family Medicine | 201 Crest Dr, Mount Olive, NC 28365-2619 | 2010-07-28 |
| 1366686271 | Arturo De Jesus De Leon | Family Medicine | 2903 Adrian Ct, Raleigh, NC 27604-5811 | 2009-04-22 |
| 1922132620 | Larry S Kilby Md Pa | Family Medicine | 1208 E St, N Wilkesboro, NC 28659-4018 | 2007-03-15 |
| 1720120470 | Carole Maxwell Stuart | Family Medicine | Lower Level Reynolds Gym-wingate Rd., Wingate Rd., Winston-salem, NC 27109 | 2007-02-12 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on ANTONIA ROSARIO TETTAMANTI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.