Dr Theresa Coddington PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

DR THERESA CODDINGTON PA

Doing business as

Theresa Coddington, PhD

Practice address

11011 King St Ste 105
Overland Park, KS 66210-1203

Phone

(913) 291-4666

NPI assigned

Jan 3, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Theresa Coddington, PHD

Title

Owner

Phone

(913) 291-4666

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Theresa Coddington, PhD Doing business as

Locations

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

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    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1346889664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 KING ST STE 105",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101203",
            "telephone_number": "913-291-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 KING ST STE 105",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101203",
            "telephone_number": "913-291-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR THERESA CODDINGTON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "CODDINGTON",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-291-4666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100384950",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Theresa Coddington, PhD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Theresa Coddington, PhD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Psychologist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.