NPIMap

Organization Active NPI

Thad Wilderson & Associates PA

  • Community/Behavioral Health Agency
  • Saint Paul, MN
National Provider Identifier
1073928701
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LP0061 Issued in MN
Legal business name
THAD WILDERSON & ASSOCIATES PA
Practice address
475 University Ave W
Saint Paul, MN 55103-1959
Phone
(651) 225-8997
NPI assigned
Jun 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Authorized official

Name
Ms. Rhonda Eaves, N/A
Title
Office & Finance Manager
Phone
(651) 225-8997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LP0061 MN Primary

Addresses

Primary practice location

475 University Ave W
Saint Paul, MN 55103-1959

Mailing address

475 University Ave W
Saint Paul, MN 55103-1959
Phone (651) 225-8997

National Provider Directory

National Provider Directory
Tax ID family
Thad Wilderson Associates PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1073928701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551031959",
            "telephone_number": "651-225-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551031959",
            "telephone_number": "651-225-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THAD WILDERSON & ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "EAVES",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "OFFICE & FINANCE MANAGER",
        "authorized_official_telephone_number": "651-225-8997",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP0061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.