Theodore D. Fifer, M.D. FACS

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

036084136 Issued in IL

Practice address

14900 N Court 9
Effingham, IL 62401-7640

Phone

(217) 994-6162

Fax

(217) 342-7094

NPI assigned

Feb 13, 2008

Last updated

Dec 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Illinois Department of Human Services

  • Intellectual Disabilities Intermediate Care Facility
  • Centralia, IL
  • NPI 1003960394
  Medicare reassignment NPD
• Illinois Department of Human Services

  • Psychiatric Hospital
  • Chester, IL
  • NPI 1306834726
  NPD
• Illinois Department of Human Services

  dba John J Madden Mental Health

  • Psychiatric Hospital
  • Hines, IL
  • NPI 1902903487
  NPD

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1508034596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14900 N COURT 9",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624017640",
            "telephone_number": "217-994-6162",
            "fax_number": "217-342-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14900 N COURT 9",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624017640",
            "telephone_number": "217-994-6162",
            "fax_number": "217-342-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFER",
        "first_name": "THEODORE",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D. FACS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "IL",
            "license": "036084136",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036084136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-084136",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "025-00076",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Care Associates of Effingham, S.C.
• Cari A. Fearday, PA-C
• Alex Feldkamp, MHP
• Sydney Feldkamp, BA
• Lauren Angela Fifer, FNP
• Amy Finley, MS
• Abagail Flach, RN, SRNA
• James J Flaig, DO
• Paige Janae Fleeman, MHP
• Stephanie Flier, MHP

• Plastic and Reconstructive Surgery Physician in Effingham, IL
• Providers in Effingham, IL by specialty
• Plastic and Reconstructive Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.