Adrea D Theodore, M.D., M.P.H.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9701880 Issued in NC

Practice address

1206-B Vaughn Road
Burlington, NC 27216

Phone

(336) 228-0813

Fax

(336) 228-7087

NPI assigned

Feb 27, 2009

Last updated

Oct 14, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Crossroads Sexual Assault Response & Resource Center Inc

  • Pediatrics Physician
  • Burlington, NC
  • NPI 1508190067
  NPD (past)
• Crossroads Sexual Assault Response and Resource Center Inc

  • Professional Counselor
  • Burlington, NC
  • NPI 1942536099
  NPD (past)

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1215177498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206-B VAUGHN ROAD",
            "address_2": "P. O. BOX 673",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27216",
            "telephone_number": "336-228-0813",
            "fax_number": "336-228-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206-B VAUGHN ROAD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27216",
            "telephone_number": "336-228-0813",
            "fax_number": "336-228-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORE",
        "first_name": "ADREA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9701880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "981199T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The R. a. Group, Inc
• The R. a. Group, Inc
• The Rehab Concierge PLLC
• The Sharpe Rd. Adult Home Care, LLC
• The Well Dispensary, LLC
• Think Well Counseling Services, PLLC
• Thomas W. Monahan, IV, DMD, PA
• Mathai S Thomas, MD
• Michael Thomas
• Stacey Hill Thomas, DNP, APRN, FNP-C

• Pediatrics Physician in Burlington, NC
• Providers in Burlington, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.