Active NPI
Theodore John, M.D.
- Surgery Physician
- Marysville, CA
National Provider Identifier
1790084010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- A143051
- Practice address
- 726 4TH St
Marysville, CA 95901-5656 - Phone
- (530) 749-4300
- NPI assigned
- Mar 25, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A143051 | CA | Primary |
Addresses
Primary practice location
726 4TH St
Marysville, CA 95901-5656
Mailing address
1221 South Dr
Mt Pleasant, MI 48858-3257
Phone (989) 779-5240
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
| License | State | Type | Specialty |
|---|---|---|---|
| A143051 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acute Care Surgery Medical Group, Inc. | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Surgery Physician
- Westminster,, CO
- NPI 1477239267
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1790084010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 SOUTH DR",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488583257",
"telephone_number": "989-779-5240",
"fax_number": "989-779-5254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 4TH ST",
"city": "MARYSVILLE",
"state": "CA",
"postal_code": "959015656",
"telephone_number": "530-749-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHN",
"first_name": "THEODORE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-25",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A143051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.