Individual provider Active NPI

Akram Saeed Al-Theblah, MS,RN,FNP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1356629620
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336837-1 Issued in NY
Practice address
750 E Adams St
Upstate University Hospital
Syracuse, NY 13210
Phone
(315) 424-7726
NPI assigned
Aug 3, 2011
Last updated
Aug 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336837-1 NY Primary

Addresses

Primary practice location

750 E Adams St
Upstate University Hospital
Syracuse, NY 13210

Mailing address

110 Steuben St
Syracuse, NY 13208-2004
Phone (315) 424-7726

Other identifiers 1

IdentifierTypeStateIssuer
F-336837-1OtherNYLICENSE NUMBER

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
Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
F336837-1NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1356629620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 STEUBEN ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132082004",
            "telephone_number": "315-424-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "UPSTATE UNIVERSITY HOSPITAL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-424-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-THEBLAH",
        "first_name": "AKRAM",
        "middle_name": "SAEED",
        "name_prefix": "Mr.",
        "credential": "MS,RN,FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336837-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "F-336837-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.