Kenneth Theriot, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

44415 Issued in AZ

Practice address

4002 E Main St Ste 1
Mesa, AZ 85205-8612

Phone

(480) 324-5421

Fax

(480) 324-5459

NPI assigned

Sep 21, 2008

Last updated

Mar 29, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Anesthesiology

Education

Medical College of Wisconsin, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chandler Anesthesia Consultants LLCGroup PAC ID 0648161810, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036
• Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ketheriot@direct.uspi.com

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.

• Chandler Anesthesia Consultants LLC

  • Anesthesiology Physician
  • Chandler, AZ
  • NPI 1881632552
  Medicare reassignment Care Compare group NPD
• Anesthesia Partners of Arizona LLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1619452901

  AZ

  Medicare reassignment NPD
• Deer Valley Anesthesia, PLLC

  • Specialist
  • Phoenix, AZ
  • NPI 1992970073
  NPD (past)
• Phoenix Anesthesia Associates PLLC

  • Anesthesiology Physician
  • Mesa, AZ
  • NPI 1023210036
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Community Care

  dba Chandler Regional Medical Center

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189
  Care Compare affiliation
• Dignity Health

  dba Mercy Gilbert Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1992735088
  Care Compare affiliation

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

{
    "created_epoch": "1221955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1114177664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18827 E SWAN DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425314",
            "telephone_number": "480-275-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 E MAIN ST STE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058612",
            "telephone_number": "480-324-5421",
            "fax_number": "480-324-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIOT",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-21",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2008015177",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "44415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jagdishkumar Thekdi
• Therapy for Developmental Disabilities
• Therapy for Developmental Disabilities, LLC
• Therapy LLC
• Therapy One, PLLC
• Therma-Scan Reference Laboratory, LLC
• Therma-Scan Reference Laboratory, LLC
• Tiffany L Therrien, MOTR/L
• Claude R Thibeault, MD
• Jeff R Thiboutot, B.S., C.N.

• Anesthesiology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.