Kay Ellen Theyerl, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

46219-020 Issued in WI

Practice address

200 Theda Clark Medical PLZ
Suite 240
Neenah, WI 54956-2721

Phone

(920) 725-2070

Fax

(920) 725-4549

NPI assigned

Aug 2, 2005

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1669473674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-996-3200",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 THEDA CLARK MEDICAL PLZ",
            "address_2": "SUITE 240",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562721",
            "telephone_number": "920-725-2070",
            "fax_number": "920-725-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEYERL",
        "first_name": "KAY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "46219-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34471300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "711290047",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thedacare Regional Medical Center-Neenah, Inc.
• Thedacare Regional Medical Center-Neenah, Inc.
• Thedacare-Peabody Manor
• Leslie Thede
• Therapy & Tattoos LLC
• Mark Robert Thiel, OTR
• Kathleen Kim Thome, MSED, LPC
• Katherine Mary Thompson, DNP
• Thrive Music Therapy LLC
• Monica Tice, PHARMD

• Internal Medicine Physician in Neenah, WI
• Providers in Neenah, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.