Karen Christiane Theilade, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

ME106807 Issued in FL

Practice address

120 Cypress Edge Dr
Suite 203
Palm Coast, FL 32164-8453

Phone

(386) 586-4410

Fax

(386) 445-3398

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Adventhealth Primary Care Network Inc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1093493637
  NPD (past)
• Memorial Hospital Flagler Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  NPD (past)
• Memorial Hospital Flagler Inc.

  • Multi-Specialty Clinic/Center
  • Palm Coast, FL
  • NPI 1558530600
  NPD (past)
• Mayo Clinic Health System in Waycross, Inc.

  • Multi-Specialty Clinic/Center
  • Waycross, GA
  • NPI 1154745982
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1750422184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CYPRESS EDGE DR",
            "address_2": "SUITE 203",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321648453",
            "telephone_number": "386-586-4410",
            "fax_number": "386-445-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CYPRESS EDGE DR",
            "address_2": "SUITE 203",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321648453",
            "telephone_number": "386-586-4410",
            "fax_number": "386-445-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEILADE",
        "first_name": "KAREN",
        "middle_name": "CHRISTIANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME106807",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME106807",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14AA4",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003120001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01170719",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Taylor
• Katherine E Taylor
• The Footwear Company LLC
• The Heart Center of Palm Coast, LLC
• The Jacob Dental Group Inc
• Therapeutic Assisted Living Corp.
• Burton W Thomas III, CAP
• Melony Kay Thomas, D.C.
• Michelle Thomas, O.T.
• Roxanne Pascoe Thomas, PHARM D

• Cardiovascular Disease Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.