MR. MARK WALTER THIEMANN (NPI# 1386634046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386634046 |
| Entity Type | Individual |
| Full Name | MR. MARK WALTER THIEMANN |
| Credential | P.A.C. |
| Practice Address |
2454 Kipling Avenue Ste 120 Cincinnati OH 45239-6600 |
| Practice Telephone | 5139816784 |
| Practice Fax Number | 5138534095 |
| Mailing Telephone | 5139816784 |
| Mailing Fax Number | 5138534095 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2013-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
50-00-0882 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0077577 | 05 | |
| OH | MEDICARE RR | PA-P00919620 | 01 |
| Street Address |
2454 KIPLING AVENUE STE 120 |
| City | CINCINNATI |
| State | OH |
| Zip Code | 45239-6600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184742934 | Ann Suttmann | Nurse Practitioner | 2454 Kipling Avenue, Cincinnati, OH 45239 | 2007-03-27 |
| 1841315033 | James A Walro | Physical Therapist | 2454 Kipling Avenue, Suite 125, Cincinnati, OH 45239 | 2007-03-20 |
| 1174648968 | Brandy Lee Angelo | Physical Therapist | 2454 Kipling Avenue, Cincinnati, OH 45239 | 2007-03-20 |
| 1427172121 | Petrina Angela Garritano | Physical Therapist | 2454 Kipling Avenue, Suite 125, Cincinnati, OH 45239 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003312786 | Personal Companions Home Care LLC | Home Health | 6225 Colerain Ave Ste C, Cincinnati, OH 45239 | 2018-04-02 |
| 1447769047 | Divine Destiny Home Care Agency | In Home Supportive Care | 6625 New Bridge Dr., Cincinnati, OH 45239 | 2017-09-26 |
| 1063939262 | Alexandra Cunningham | Registered Nurse | 5730 Colerain Ave., Cincinnati, OH 45239 | 2017-08-28 |
| 1598289803 | Jeanise D Randolph | Case Manager/Care Coordinator | 3425 North Bend Suite F, Cincinnati, OH 45239 | 2017-07-28 |
| 1407385925 | Odessey Residential Homes LLC | Assisted Living Facility | 8240 Pippin Rd, Cincinnati, OH 45239 | 2017-06-08 |
| 1841727625 | Danita Marie White | Counselor | 5887 Montfort Hills Ave. #3, Cincinnati, OH 45239 | 2017-05-11 |
| 1801249867 | Regina Gullette | Counselor | 5980 Colerain Ave, 36, Cincinnati, OH 45239 | 2016-07-14 |
| 1811393051 | Angela Bien | Psychologist | 3420 Banning Road, Cincinnati, OH 45239 | 2014-11-17 |
| 1568895076 | Shavonne Noble | Registered Nurse | 1830 Sundale Ave, Cincinnati, OH 45239 | 2013-08-20 |
| 1609216613 | Eusebio Tiu Gaw | Surgery | 3515 Banning Rd., Cincinnati, OH 45239 | 2013-07-05 |
| Find all providers in zip 45239 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669619482 | Jennifer Miller | Physician Assistant | 644 Eden Park Dr, Cincinnati, OH 45202-6031 | 2009-01-15 |
| 1093769515 | Gregory S. Newkirk | Physician Assistant | 500 E Business Way Ste A, Cincinnati, OH 45241-2374 | 2006-05-20 |
| 1700839529 | Steven D. Kinzer | Physician Assistant | 2454 Kipling Ave, Ste 120, Cincinnati, OH 45239-6650 | 2006-05-19 |
| 1760472435 | Sarah Lynn Buchert | Physician Assistant | 3249 Glenmore Ave, Cincinnati, OH 45211-6637 | 2005-10-25 |
| 1487173506 | Nicholas Garrett Rittle | Physician Assistant | 234 Goodman St, Cincinnati, OH 45219 | 2017-09-11 |
| 1386091593 | Kaitlyn Elizabeth Kaiser | Physician Assistant | 231 Albert Sabin Way, Cincinnati, OH 45267-2722 | 2016-05-17 |
| 1164893020 | Kevin Brown | Physician Assistant | 8311 Montgomery Rd, Cincinnati, OH 45236-2227 | 2015-10-16 |
| 1033545884 | Jamie Lee Miller | Physician Assistant | 500 E Business Way, Cincinnati, OH 45241-2374 | 2013-09-24 |
| 1841625951 | Mollyrose M Wannamaker | Physician Assistant | 234 Goodman St, Cincinnati, OH 45219 | 2013-09-08 |
| 1285072702 | Nicholas S Music | Physician Assistant | 6480 Harrison Ave, Suite 201, Cincinnati, OH 45247-7961 | 2013-06-06 |
| Find all providers in CINCINNATI | ||||
| City | CINCINNATI |
| Zip Code | 45239 |
Please comment or provide details below to improve the information on MR. MARK WALTER THIEMANN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.