Organization Active NPI

William J Thieman MD PC

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1457536187
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19190 Issued in CO
Legal business name
WILLIAM J THIEMAN MD PC
Practice address
1217 East Elizabeth
Suite 1
Fort Collins, CO 80524-4040
Phone
(970) 484-7245
Fax
(970) 484-1398
NPI assigned
Dec 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Authorized official

Name
Mrs. Eileen Morgan Thieman
Title
Office Manager Corporate Secretary
Phone
(970) 484-7245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 19190 CO Primary

Addresses

Primary practice location

1217 East Elizabeth
Suite 1
Fort Collins, CO 80524-4040

Mailing address

1217 East Elizabeth
Suite 1
Fort Collins, CO 80524-4040
Phone (970) 484-7245

Other identifiers 1

IdentifierTypeStateIssuer
01191907MedicaidCO

National Provider Directory

National Provider Directory

Locations

1217 E Elizabeth St
Ste 1
Fort Collins, CO 80524
Phone (970) 484-7245

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1457536187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 EAST ELIZABETH",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244040",
            "telephone_number": "970-484-7245",
            "fax_number": "970-484-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 EAST ELIZABETH",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244040",
            "telephone_number": "970-484-7245",
            "fax_number": "970-484-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J THIEMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "THIEMAN",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "MORGAN",
        "authorized_official_title_or_position": "OFFICE MANAGER CORPORATE SECRETARY",
        "authorized_official_telephone_number": "970-484-7245",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "19190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01191907",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.