MRS. THERESA MONTGOMERY TYRIE (NPI# 1649753468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649753468 |
| Entity Type | Individual |
| Full Name | MRS. THERESA MONTGOMERY TYRIE |
| Other Name | MISS THERESA RENAE MONTGOMERY |
| Credential | ARNP |
| Practice Address |
2021 N Crooked Branch Dr Lecanto FL 34461-9453 |
| Practice Telephone | 3524364428 |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP9293072 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2021 N CROOKED BRANCH DR |
| City | LECANTO |
| State | FL |
| Zip Code | 34461-9453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053379735 | Lakshmi Narayana N Padala | Family Medicine | 2021 N Crooked Branch Dr, Lecanto, FL 34461-9453 | 2006-05-03 |
| 1447505227 | Padala Family Practice, Pllc | Allergy & Immunology | 2021 N Crooked Branch Dr, Lecanto, FL 34461-9453 | 2012-07-18 |
| 1891726741 | German E. Baldeon | Internal Medicine | 2021 N Crooked Branch Dr, Lecanto, FL 34461-9453 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891261160 | Shekinah Barfield | Physician Assistant | Pediatric and Internal Medicine Specialist Inc, 1990 N Prospect Ave, Lecanto, FL 34461 | 2018-10-15 |
| 1699240887 | Medical Risk Solutions | Family Medicine | 2804 W. Marc Knighton Court Key #10, Lecanto, FL 34461 | 2018-10-04 |
| 1851848097 | Pedim Outreach and Specialty Clinic LLC | Family Medicine | 1982 N Prospect Ave, Lecanto, FL 34461 | 2016-09-06 |
| 1265776579 | Wal-mart Stores East Lp | Technician/Technologist | 1936 N. Lecanto Hwy, Lecanto, FL 34461 | 2012-11-27 |
| 1922306109 | Pediatric and Internal Medicine Specialists, Pa | Clinic/Center | 1980 North Prospect Avenue, Lecanto, FL 34461 | 2011-03-11 |
| 1942459078 | Crq Enterprises LLC | Home Health | 4214 W Gulf To Lake Hwy, Lecanto, FL 34461 | 2008-09-12 |
| 1548418064 | Thomas Tybeck | Counselor | 324 S Kensington Ave Ste 328, Lecanto, FL 34461 | 2008-09-09 |
| 1356533566 | Amanda Nicole Coppedge | Optometrist | 240 N. Lecanto Hwy., Lecanto, FL 34461 | 2007-08-11 |
| 1679779185 | Brashears Vital Care Corp | Pharmacy | 471 N Dacie Pt, Lecanto, FL 34461 | 2007-06-22 |
| 1285751099 | Interim Healthcare Private Services, Inc. | Home Health | 581 E. Gulf To Lake Highway, Village West Plaza, Lecanto, FL 34461 | 2007-03-25 |
| Find all providers in zip 34461 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649600503 | Ellen Daly | Nurse Practitioner | 2385 N Lecanto Hwy, Lecanto, FL 34461-9677 | 2013-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193292 | Paulette Vital-herne | Nurse Practitioner | 4449 Old Highway 41 S, Sun City, FL 33586-9700 | 2020-10-26 |
| 1144828104 | Shilpa Narahari Reddy | Nurse Practitioner | 19435 N Coquina Way, Weston, FL 33332-2417 | 2020-10-13 |
| 1023615440 | Bridget Mary Rossi | Nurse Practitioner | 1536 Alford Street, Unit 5, Jacksonville, FL 32207-3220 | 2020-10-08 |
| 1154928612 | Haili Harless | Nurse Practitioner | 3961 23rd Ave N, Saint Petersburg, FL 33713-4850 | 2020-10-07 |
| 1679170674 | Lorena Beatriz Canelon | Nurse Practitioner | 16151 Sw 147th Ln, Miami, FL 33196-6416 | 2020-10-04 |
| 1851998082 | Sanon Edmond | Nurse Practitioner | 5236 Arbor Glen Cir, Lake Worth, FL 33463-8066 | 2020-10-01 |
| 1710594114 | Sumelia Waddell | Nurse Practitioner | 462 Ne 210th Circle Ter Apt 204, Miami, FL 33179-5236 | 2020-09-29 |
| 1780291526 | Ilmary De Los Angeles Jimenez | Nurse Practitioner | 7909 Biltmore Blvd, Miramar, FL 33023-5829 | 2020-09-25 |
| 1972119535 | Dennis Carmelo Cadiz Serfino | Nurse Practitioner | 1960 Willesdon Dr E, Jacksonville, FL 32246-0694 | 2020-09-18 |
| 1760097745 | Amanee Orra | Nurse Practitioner | 3982 Bee Ridge Rd Ste H-a, Sarasota, FL 34233-1211 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
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| 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.