Individual provider Active NPI

Robert James Thoemke, PA

  • Medical Physician Assistant
  • McQueeney, TX
National Provider Identifier
1285631093
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00945 Issued in TX
Practice address
3556 FM 78
MC Queeney, TX 78123-3537
Phone
(830) 560-2813
Fax
(830) 560-2812
NPI assigned
Jul 7, 2005
Last updated
Jan 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00945 TX Primary

Addresses

Primary practice location

3556 FM 78
MC Queeney, TX 78123-3537

Mailing address

8637 Fredericksburg Rd
Suite 105
San Antonio, TX 78240-1283
Phone (210) 949-4179

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)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00945TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
HMG Medical Group, P.a. Past Accepting new patients
HMG Medical 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1285631093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8637 FREDERICKSBURG RD",
            "address_2": "SUITE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401283",
            "telephone_number": "210-949-4179",
            "fax_number": "210-617-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3556 FM 78",
            "city": "MC QUEENEY",
            "state": "TX",
            "postal_code": "781233537",
            "telephone_number": "830-560-2813",
            "fax_number": "830-560-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOEMKE",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McQueeney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.