Thelma Louise Chisholm, MD

Primary specialty

Therapeutic Radiology PhysicianTaxonomy code 2085R0203X

License

ME85941 Issued in FL

Practice address

1600 Lakeland Hills Blvd
Lakeland, FL 33805

Phone

(863) 680-7000

Fax

(866) 264-8519

NPI assigned

Jan 27, 2006

Last updated

Jun 12, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Watson Clinic LLP

  • Clinical Medical Laboratory
  • Lakeland, FL
  • NPI 1558409730
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1649241852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95004",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33804",
            "telephone_number": "863-680-7206",
            "fax_number": "863-680-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "THELMA",
        "middle_name": "LOUISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "FL",
            "license": "ME85941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265428800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerold Norman Chip I, MD
• Lilliam S. Chiques-Colon, MD
• Chiromed Wellness Centers LLC
• Chiropractic Center of Lakeland Inc
• Chiropractic Center of Lakeland South, Inc (Love Chiropractic Center)
• David Wayne Choate, D.C
• Harish M Chokshi, MD
• Orestes Chongo Pedroso
• Christine H Christensen, APRN
• Rebecca Christian, LMHC

• Therapeutic Radiology Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Therapeutic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.