Individual provider Active NPI

Theresa Marie Menton, DO

  • Emergency Medicine Physician
  • Salem, VA
National Provider Identifier
1306424056
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102208687 Issued in VA
Practice address
1900 Electric Rd
Salem, VA 24153-7474
Phone
(540) 776-4000
NPI assigned
Apr 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0102208687 VA Primary

Addresses

Primary practice location

1900 Electric Rd
Salem, VA 24153-7474

Mailing address

1900 Electric Rd
Salem, VA 24153-7474

Other names 1

  • Dr. Theresa Ferguson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20241014000093 VA Practitioner - Emergency Medicine 6507398708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Spring Emergency Group LLCGroup PAC ID 6406103498, 51 clinicians

Practice addresses (Care Compare)

1900 Electric Rd
Salem, VA 24153-7474
Phone (540) 776-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102208687VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Spring Emergency Group, LLC Emergency Medicine CurrentSince Aug 15, 2024 Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

1423 W Ruritan Rd
Roanoke, VA 24012
Phone (540) 945-9900

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1306424056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 ELECTRIC RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ELECTRIC RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537474",
            "telephone_number": "540-776-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTON",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102208687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "FERGUSON",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.