Active NPI
Theresa L. Luken, M.D.
- Internal Medicine Physician
- Columbus, OH
National Provider Identifier
1790763092
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 20, 2021.
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35-063730
- Practice address
- 4300 Clime Rd
Suite 110
Columbus, OH 43228-6491 - Phone
- (614) 308-9066
- Fax
- (614) 308-0028
- NPI assigned
- Jan 6, 2006
- Last updated
- Apr 8, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35-063730 | OH | Primary |
Addresses
Primary practice location
4300 Clime Rd
Suite 110
Columbus, OH 43228-6491
Mailing address
PO Box 713256
Columbus, OH 43271-0001
Phone (440) 777-6017
Other names 1
- Theresa Brown
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-063730 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Ohio Emergency Services, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207612800000",
"number": "1790763092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 713256",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432710001",
"telephone_number": "440-777-6017",
"fax_number": "440-777-6940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 CLIME RD",
"address_2": "SUITE 110",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432286491",
"telephone_number": "614-308-9066",
"fax_number": "614-308-0028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUKEN",
"first_name": "THERESA",
"middle_name": "L.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-06",
"last_updated": "2008-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35-063730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "THERESA",
"last_name": "BROWN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.