Individual provider Active NPI

Lee Parks Theaker, MD

  • Anesthesiology Physician
  • Wheeling, WV
National Provider Identifier
1437247160
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35067781T Issued in OH
Practice address
2000 Eoff St
Wheeling, WV 26003-3823
Phone
(304) 234-0123
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35067781T OH Primary

Addresses

Primary practice location

2000 Eoff St
Wheeling, WV 26003-3823

Mailing address

2000 Eoff St
Wheeling, WV 26003-3823
Phone (304) 234-0123

Other identifiers 1

IdentifierTypeStateIssuer
2020422MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20051220000319 OH Practitioner - Anesthesiology 3072535962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wright State University Boonshoft School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeling Hospital Ambulatory Surgery Center LLCGroup PAC ID 8123354743, 25 clinicians

Practice addresses (Care Compare)

68 State Route 7
Bridgeport, OH 43912-1642
Phone (740) 676-6600

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35067781TOHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital Ambulatory Surgery Center LLC CurrentSince Aug 28, 2023 Accepting new patients
Trinity Anesthesiology Associates Anesthesiology Past Accepting new patients

Locations

68 State Route 7
Bridgeport, OH 43912
Phone (740) 676-6600

109 Mount Wood Rd
#1
Wheeling, WV 26003

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1437247160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823",
            "telephone_number": "304-234-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823",
            "telephone_number": "304-234-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEAKER",
        "first_name": "LEE",
        "middle_name": "PARKS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35067781T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2020422",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.