Thanom Temiyasathit, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036-054080 Issued in IL

Practice address

1302 Franklin Ave
Suite 4500
Normal, IL 61761-3551

Phone

(309) 828-1166

Fax

(309) 862-0330

NPI assigned

Jul 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bromenn Healthcare, Inc.

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1184808404
  NPD (past)
• Illinois Cardiac Surgery Associates SC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Peoria, IL
  • NPI 1114018439
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023041175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE",
            "address_2": "SUITE 4500",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551",
            "telephone_number": "309-828-1166",
            "fax_number": "309-862-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE",
            "address_2": "SUITE 4500",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551",
            "telephone_number": "309-828-1166",
            "fax_number": "309-862-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMIYASATHIT",
        "first_name": "THANOM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-054080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "008003",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GROUP NUMBER",
            "identifier": "05732097",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054080",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jayul Tailor, MD
• Stephanie E Tate, MD
• Korine M Tatroe
• Taylor Ashton Taylor, MSN, APN, FNP-BC
• Juliet Dimayuga Tecson, APRN, FNP-C
• Andrew Terry, RN
• Jugal R Thaker, MD
• Thatcher Therapy LLC
• The Baby Fold
• The Baby Fold

• Cardiovascular Disease Physician in Normal, IL
• Providers in Normal, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.