Theodore a Buccilli Jr DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36003352 Issued in OH

Legal business name

THEODORE A BUCCILLI JR DPM

Practice address

116 East Ave
Tallmadge, OH 44278-2328

Phone

(330) 633-3445

Fax

(330) 633-6028

NPI assigned

Apr 26, 2006

Organization subpart

No

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

Authorized official

Name

Susan Cerimele

Title

Billing

Phone

(330) 633-3445

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528024619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 EAST AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782328",
            "telephone_number": "330-633-3445",
            "fax_number": "330-633-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 EAST AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782328",
            "telephone_number": "330-633-3445",
            "fax_number": "330-633-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE A BUCCILLI JR DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CERIMELE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "330-633-3445"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan J Terhune Jr., DMD
• Lisa Dawn Teter, LSW
• The Cleveland Clinic Foundation
• The Tamarkin Company
• The Well Co Therapy, LLC
• Amber Thomas
• Emily Thomas
• Alexandra Thompson
• Anais Thompson
• Judy Thompson, SLP

• Podiatrist in Tallmadge, OH
• Providers in Tallmadge, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.