Individual provider Active NPI

Sheetal Thaker, MD

  • Emergency Medicine Physician
  • Tucson, AZ
National Provider Identifier
1699093518
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
51707 Issued in AZ
Practice address
1925 W River Rd
Apartment #9107
Tucson, AZ 85704-1464
Phone
(732) 824-2583
NPI assigned
May 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT197572 PA
Student in an Organized Health Care Education/Training Program 390200000X MT197572 PA
Emergency Medicine Physician 207P00000X P5139 TX
Emergency Medicine Physician 207P00000X 51707 AZ Primary

Addresses

Primary practice location

1925 W River Rd
Apartment #9107
Tucson, AZ 85704-1464

Mailing address

1925 W River Rd
Apartment #9107
Tucson, AZ 85704-1464
Phone (732) 824-2583

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51707AZMDEmergency Medicine Physician
P5139TXMDEmergency Medicine Physician
MT197572PAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1699093518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 W RIVER RD",
            "address_2": "APARTMENT #9107",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041464",
            "telephone_number": "732-824-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 W RIVER RD",
            "address_2": "APARTMENT #9107",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041464",
            "telephone_number": "732-824-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKER",
        "first_name": "SHEETAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT197572",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT197572",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P5139",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "51707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.