Individual provider Active NPI

Theodore J Alexander, DO

  • Internal Medicine Physician
  • Canfield, OH
National Provider Identifier
1053302877
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34002510A Issued in OH
Practice address
4129 Pebble Beach Dr
Canfield, OH 44406-9527
Phone
(330) 758-4515
Fax
(330) 758-5121
NPI assigned
Nov 1, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34002510A OH Primary

Addresses

Primary practice location

4129 Pebble Beach Dr
Canfield, OH 44406-9527

Mailing address

4129 Pebble Beach Dr
Canfield, OH 44406-9527
Phone (330) 758-4515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111112000019 OH Practitioner - Internal Medicine 5890969695 Practice locations: Canfield, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34002510AOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. T. Alexander Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1053302877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4129 PEBBLE BEACH DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069527",
            "telephone_number": "330-758-4515",
            "fax_number": "330-758-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4129 PEBBLE BEACH DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069527",
            "telephone_number": "330-758-4515",
            "fax_number": "330-758-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "THEODORE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34002510A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canfield, OH

Sources for this page

Verify at the official NPI Registry.