Judith Thierry, D.O.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

5101008729 Issued in MI

Practice address

Exit 102 Off I-40 1/2 Mi South
San Fidel, NM 87049-0130

Phone

(505) 552-5385

Fax

(505) 552-5473

NPI assigned

Jan 14, 2008

Last updated

Jan 14, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Acoma Canoncito Laguna Indian

  dba DHHS Usphs Indian Health Services

  • Ambulance
  • San Fidel, NM
  • NPI 1649462532
  NPD (past)
• Acoma-Canoncito-Laguna Indian Health Center

  • Health Service Clinic/Center
  • Acoma, NM
  • NPI 1225103922
  NPD (past)

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1881870426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "SAN FIDEL",
            "state": "NM",
            "postal_code": "870490130",
            "telephone_number": "505-552-5385",
            "fax_number": "505-552-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EXIT 102 OFF I-40 1/2 MI SOUTH",
            "city": "SAN FIDEL",
            "state": "NM",
            "postal_code": "870490130",
            "telephone_number": "505-552-5385",
            "fax_number": "505-552-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIERRY",
        "first_name": "JUDITH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101008729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mona Sarrai, M.D.
• Linda Maurine Schultz, M.D.
• Scarlet Danielle Southern, RPH
• Francis Charles Steyaert, DDS MSD
• Alan Filip Tatz, DDS
• Gerard Anthony Tomkie, D.D.S.
• Eleanor P Toya, SW
• Jonathan Neil Trujillo, PHARMD
• US Dept. Health & Human Services - Usphs Indian Health Services (New Sunrise Regional Treatment Center)
• Amber D Vancamp

• General Practice Physician in San Fidel, NM
• Providers in San Fidel, NM by specialty
• General Practice Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.