Active NPI
William J Thieman MD PC
- Family Medicine Physician
- Fort Collins, CO
National Provider Identifier
1457536187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 19190
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01191907 | Medicaid | CO |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Medicine Physician
- Fort Collins, CO
- NPI 1588748842
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.