Individual provider Active NPI

Teresa Marie Todd, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Lufkin, TX
National Provider Identifier
1285643742
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
K0720 Issued in TX
Practice address
505 South John Redditt Drive
Department of Pathology
Lufkin, TX 75904-3120
Phone
(936) 634-8311
Fax
(936) 637-8545
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X K0720 TX Primary

Addresses

Primary practice location

505 South John Redditt Drive
Department of Pathology
Lufkin, TX 75904-3120

Mailing address

PO Box 1907
Greenville, TX 75403-1907
Phone (936) 632-5920

Other identifiers 1

IdentifierTypeStateIssuer
8R9360OtherTXBLUE CROSS BLUE SHIELD TX

Other names 1

  • Teresa Marie Donovan Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040803000960 TX Practitioner - Pathology 6305817438 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Teresa D Todd MD PA Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2005 Accepting new patients
Teresa D Todd MD PA CurrentSince Jan 1, 2005 Accepting new patients

Locations

505 S John Redditt Dr
#R
Lufkin, TX 75904
Phone (936) 632-5992

700 Gaslight Blvd
Lufkin, TX 75904
Phone (936) 632-5920

505 S John Redditt Dr
Lufkin, TX 75904
Phone (713) 512-1200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1902/brand/6/csg/45/fhir/r4

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1285643742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1907",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754031907",
            "telephone_number": "936-632-5920",
            "fax_number": "936-632-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 SOUTH JOHN REDDITT DRIVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043120",
            "telephone_number": "936-634-8311",
            "fax_number": "936-637-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "TERESA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "K0720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "8R9360",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "DONOVAN",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.