Active NPI
Courtney Thebodo
- Pharmacist
- Charlton, MA
National Provider Identifier
1801512132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 240406
- Practice address
- 142 Worcester Rd
Charlton, MA 01507-1244 - Phone
- (508) 248-5473
- NPI assigned
- Oct 18, 2022
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 240406 | MA | Primary |
Addresses
Primary practice location
142 Worcester Rd
Charlton, MA 01507-1244
Mailing address
130 Heritage Dr
Whitinsville, MA 01588-2363
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240406 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1801512132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 HERITAGE DR",
"city": "WHITINSVILLE",
"state": "MA",
"postal_code": "015882363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 WORCESTER RD",
"city": "CHARLTON",
"state": "MA",
"postal_code": "015071244",
"telephone_number": "508-248-5473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEBODO",
"first_name": "COURTNEY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-18",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "240406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.