Individual provider Active NPI

Teresa Marie Wertheimer, MD

  • General Practice Physician
  • Okemos, MI
National Provider Identifier
1811223498
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4301048709 Issued in MI
Practice address
2134 Hampton PL
Okemos, MI 48864-3691
Phone
(517) 347-3000
Fax
(517) 347-8393
NPI assigned
Nov 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4301048709 MI Primary

Addresses

Primary practice location

2134 Hampton PL
Okemos, MI 48864-3691

Mailing address

2134 Hampton PL
Okemos, MI 48864-3691
Phone (517) 347-3000

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

LicenseStateTypeSpecialty
4301048709MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William T Mangan Jr, DO PLLC PastSince Jul 1, 2005 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.

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1811223498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2134 HAMPTON PL",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643691",
            "telephone_number": "517-347-3000",
            "fax_number": "517-347-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2134 HAMPTON PL",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643691",
            "telephone_number": "517-347-3000",
            "fax_number": "517-347-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTHEIMER",
        "first_name": "TERESA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301048709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.