Individual provider Active NPI

Megan Lynn Thiedeman, M.S.S.

  • Athletic Trainer
  • San Antonio, TX
National Provider Identifier
1710180286
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
9502 Huebner Road
Suite 301
San Antonio, TX 78240
Phone
(210) 478-5332
Fax
(210) 478-5384
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

9502 Huebner Road
Suite 301
San Antonio, TX 78240

Mailing address

2533 Grayson Way
San Antonio, TX 78232-1836
Phone (210) 478-5332

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710180286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2533 GRAYSON WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321836",
            "telephone_number": "210-478-5332",
            "fax_number": "210-478-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9502 HUEBNER ROAD",
            "address_2": "SUITE 301",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78240",
            "telephone_number": "210-478-5332",
            "fax_number": "210-478-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEDEMAN",
        "first_name": "MEGAN",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "M.S.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

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.

Verify at the official NPI Registry.