Poua Thao, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5474 Issued in MN

Practice address

964 Inwood Ave N
Oakdale, MN 55128-6625

Phone

(651) 621-2206

Fax

(651) 578-8587

NPI assigned

Jan 3, 2011

Last updated

May 4, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Little Canada Medical Clinic

  • Primary Care Clinic/Center
  • Little Canada, MN
  • NPI 1174836597
  NPD (past)

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1518261791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6798 HADLEY AVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550161073",
            "telephone_number": "651-621-2206",
            "fax_number": "651-578-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 INWOOD AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286625",
            "telephone_number": "651-621-2206",
            "fax_number": "651-578-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAO",
        "first_name": "POUA",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-03",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Sydlewski
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• Ashley Takekawa, PT
• Mary Theresa Tate
• Jon D. Tessar, D.D.S.
• Therapy Partners Inc
• Katherine K Thomas, PSYD.
• Keliana Thompson, MA
• Thrive Mental Health LTD
• Thrive Therapy and Wellness LLC

• Chiropractor in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; 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.