Active NPI
Terrill E. Theman, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- East Stroudsburg, PA
National Provider Identifier
1346292455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- MD039395L
- Practice address
- 206 E Brown St
East Stroudsburg, PA 18301-3006 - Phone
- (570) 421-4000
- Fax
- (570) 476-3754
- NPI assigned
- May 17, 2006
- Last updated
- Oct 5, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | MD039395L | PA | Primary |
Addresses
Primary practice location
206 E Brown St
East Stroudsburg, PA 18301-3006
Mailing address
PO Box 827658
Philadelphia, PA 19182-7658
Phone (570) 476-3507
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000922464 | Medicaid | PA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349395200000",
"number": "1346292455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 827658",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191827658",
"telephone_number": "570-476-3507",
"fax_number": "570-476-3754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 E BROWN ST",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183013006",
"telephone_number": "570-421-4000",
"fax_number": "570-476-3754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEMAN",
"first_name": "TERRILL",
"middle_name": "E.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2012-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "PA",
"license": "MD039395L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000922464",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
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- Kenneth N Thomas, MHS LCADC CAC DP LPC
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- Emily Thran
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.