NPIMap

Organization Active NPI

Joseph Thevenin Jr, MD PA

  • Internal Medicine Physician
  • Palmetto Bay, FL
National Provider Identifier
1760784268
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0061428 Issued in FL
Legal business name
JOSEPH THEVENIN JR, MD PA
Practice address
9635 SW 181 Terrace
Palmetto Bay
Palmetto Bay, FL 33157-5630
Phone
(305) 238-8561
Fax
(305) 238-4089
NPI assigned
Dec 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
Joseph Thevenin Jr, MD Jr., MD
Title
Medical Doctor
Phone
(305) 238-8561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0061428 FL Primary

Addresses

Primary practice location

9635 SW 181 Terrace
Palmetto Bay
Palmetto Bay, FL 33157-5630

Mailing address

9635 SW 181 Terrace
Palmetto Bay, FL 33157-5630
Phone (305) 238-8561

Other identifiers 1

IdentifierTypeStateIssuer
059735001MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1760784268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9635 SW 181 TERRACE",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331575630",
            "telephone_number": "305-238-8561",
            "fax_number": "305-238-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 SW 181 TERRACE",
            "address_2": "PALMETTO BAY",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331575630",
            "telephone_number": "305-238-8561",
            "fax_number": "305-238-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH THEVENIN JR, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "THEVENIN JR, MD",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "305-238-8561",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0061428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "059735001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.