Individual provider Active NPI

Theresa Mary Neumann, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1154548667
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0001607 Issued in MD
Practice address
172 Stanmore Rd
Baltimore, MD 21212-1131
Phone
(410) 821-7055
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0001607 MD Primary

Addresses

Primary practice location

172 Stanmore Rd
Baltimore, MD 21212-1131

Mailing address

172 Stanmore Rd
Baltimore, MD 21212-1131
Phone (410) 821-7055

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0001607MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Physician Services of Maryland, PC Physician Assistant Past Accepting new patients
Medlantic Healthcare Group Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154548667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 STANMORE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121131",
            "telephone_number": "410-821-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 STANMORE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121131",
            "telephone_number": "410-821-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUMANN",
        "first_name": "THERESA",
        "middle_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0001607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • 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.