Active NPI
Wladimir Thielen, ADVANCED PRACTICE
- Nurse Practitioner
- Durham, NC
National Provider Identifier
1497203137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP9316935
- Practice address
- 1326 Fairmont St
Durham, NC 27713-8979 - Phone
- (786) 300-6009
- NPI assigned
- Sep 12, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP9316935 | FL | Primary |
Addresses
Primary practice location
1326 Fairmont St
Durham, NC 27713-8979
Mailing address
1326 Fairmont St
Durham, NC 27713-8979
Phone (786) 300-6009
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9316935 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473638400000",
"number": "1497203137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1326 FAIRMONT ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277138979",
"telephone_number": "786-300-6009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1326 FAIRMONT ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277138979",
"telephone_number": "786-300-6009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIELEN",
"first_name": "WLADIMIR",
"credential": "ADVANCED PRACTICE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-12",
"last_updated": "2016-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP9316935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.