Active NPI
Tara A Thiel, O.D.
- Optometrist
- Tampa, FL
National Provider Identifier
1609919604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC 3689
- Practice address
- 8102 Citrus Park Dr
JC Penney Optical
Tampa, FL 33625 - Phone
- (813) 926-6288
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC 3689 | FL | Primary |
Addresses
Primary practice location
8102 Citrus Park Dr
JC Penney Optical
Tampa, FL 33625
Mailing address
2031 8TH St N
St Petersburg, FL 33704-3246
Phone (727) 804-4632
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC 3689 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609919604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2031 8TH ST N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337043246",
"telephone_number": "727-804-4632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8102 CITRUS PARK DR",
"address_2": "JC PENNEY OPTICAL",
"city": "TAMPA",
"state": "FL",
"postal_code": "33625",
"telephone_number": "813-926-6288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIEL",
"first_name": "TARA",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC 3689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.