Theodora Koktsidis, HEALTH ADMINISTRATOR

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

346 Fox Trail CT
Hobart, IN 46342-2351

Phone

(219) 677-7018

Fax

(219) 940-9429

NPI assigned

Feb 25, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Theodora Koktsidis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Mobile Healthcare of Northwest Indiana, LLC

  • Home Health Agency
  • Hobart, IN
  • NPI 1427298892
  NPD (past) Authorized official

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1194965558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 FOX TRAIL CT",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463422351",
            "telephone_number": "219-677-7018",
            "fax_number": "219-940-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 FOX TRAIL CT",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463422351",
            "telephone_number": "219-677-7018",
            "fax_number": "219-940-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKTSIDIS",
        "first_name": "THEODORA",
        "name_prefix": "Ms.",
        "credential": "HEALTH ADMINISTRATOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THEODORA",
            "last_name": "KOKTSIDIS",
            "prefix": "MS.",
            "credential": "MEDICAL ASSISTANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bryan King, D.O.
• Richard Kirby
• Jennifer Lynn Klaich, NP-C
• Madeline Klauer, RN
• Morgan A Kobitka, MSW, LSW
• Lindsey Marie Kolakoski, PMHNP-BC
• Koppolu P Sarma MD Inc
• Christina M Korem, FNP-C
• Maureen Kozlow, PA-C
• Mary P Kustron

• Community Health Worker in Hobart, IN
• Providers in Hobart, IN by specialty
• Community Health Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.