Jason Theodore

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4615 Meredeth St Apt 6
Lincoln, NE 68506-4973

Phone

(347) 449-1387

NPI assigned

Feb 27, 2019

Sex

Male

Sole proprietor

Yes

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Freedom House Recovery Center IncGroup PAC ID 5193898229, 12 clinicians

The Neil Group IncGroup PAC ID 2365581196, 19 clinicians

Mission Health Community Multispecialty Providers LLCGroup PAC ID 9537468574, 601 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Mission Hospital and Asheville Surgery Ce Hospital, Asheville, NC, CCN 340002

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Physician Assistant

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 and National Provider Directory roles.

• The Neil Group, Inc

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1518142280
  Medicare reassignment Care Compare group NPD (past)
• Freedom House Recovery Center, Inc.

  • Community/Behavioral Health Agency
  • Roxboro, NC
  • NPI 1093986523
  Medicare reassignment Care Compare group
• Mission Health Community Multispecialty Providers, LLC

  • Anesthesiology Physician
  • Asheville, NC
  • NPI 1457719130
  Medicare reassignment Care Compare group
• DLP Wilson Physician Practices LLC

  • Family Medicine Physician
  • Wilson, NC
  • NPI 1932521010

  Physician Assistant

  Medicare reassignment NPD
• DLP Wilson Physician Practices LLC

  • Rural Health Clinic/Center
  • Wilson, NC
  • NPI 1992482079
  NPD
• Freedom House Recovery Center

  • Community/Behavioral Health Agency
  • Warrenton, NC
  • NPI 1720352453
  NPD
• Freedom House Recovery Center, Inc.

  • Community/Behavioral Health Agency
  • Chapel Hill, NC
  • NPI 1548490378
  NPD
• Mission Community Anesthesiology Specialists LLC

  • Certified Respiratory Therapist
  • Asheville, NC
  • NPI 1528538766
  NPD
• Mission Community Anesthesiology Specialists LLC

  • Audiologist
  • Asheville, NC
  • NPI 1750851150
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• MH Mission Hospital, LLLP

  • General Acute Care Hospital
  • Asheville, NC
  • NPI 1962987677
  Care Compare affiliation

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1629535521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 MEREDETH ST APT 6",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685064973",
            "telephone_number": "347-449-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 MEREDETH ST APT 6",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685064973",
            "telephone_number": "347-449-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORE",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke Theimer
• Thekey of Nebraska, LLC
• Kelly Lynn Thelen, APRN
• Kyle Thelen
• Hanna Theobald, APRN-NP, WHNP-BC
• Therapeutic Services LLC
• Therapykate PC
• McKayla Therkildsen
• Justine Elizabeth Therrien
• Katelyn Theye

• Physician Assistant in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.