Active NPI
Todd Michael Thieman
- Driver
- Wyoming, MN
National Provider Identifier
1013359579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 377643
- Practice address
- 204 Hawthorne Rd
Wyoming, MN 55092-9717 - Phone
- (651) 464-7444
- Fax
- (651) 464-7444
- NPI assigned
- Jul 25, 2013
- Last updated
- Jul 25, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 377643 | MN | Primary |
Addresses
Primary practice location
204 Hawthorne Rd
Wyoming, MN 55092-9717
Mailing address
204 Hawthorne Rd
Wyoming, MN 55092-9717
Phone (651) 464-7444
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 377643 | MN | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374710400000",
"number": "1013359579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 HAWTHORNE RD",
"city": "WYOMING",
"state": "MN",
"postal_code": "550929717",
"telephone_number": "651-464-7444",
"fax_number": "651-464-7444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 HAWTHORNE RD",
"city": "WYOMING",
"state": "MN",
"postal_code": "550929717",
"telephone_number": "651-464-7444",
"fax_number": "651-464-7444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIEMAN",
"first_name": "TODD",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-25",
"last_updated": "2013-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "MN",
"license": "377643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.