DR. THEODORE WEBSTER ETLING JR. (NPI# 1497063424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497063424 |
| Entity Type | Individual |
| Full Name | DR. THEODORE WEBSTER ETLING JR. |
| Credential | PSYD |
| Practice Address |
10474 W Thunderbird Blvd 200 Sun City AZ 85351-3023 |
| Practice Telephone | 6233777410 |
| Practice Fax Number | 8555230513 |
| Mailing Telephone | 6233777410 |
| Mailing Fax Number | 8555230513 |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2017-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 4204 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 644018 | 05 |
| Street Address |
10474 W THUNDERBIRD BLVD 200 |
| City | SUN CITY |
| State | AZ |
| Zip Code | 85351-3023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972599058 | Amir I Buljina | Physical Medicine & Rehabilitation | 10474 W Thunderbird Blvd, Suite 200, Sun City, AZ 85351 | 2005-09-23 |
| 1245846690 | Jacob Brauning | Physical Medicine & Rehabilitation | 10474 W Thunderbird Blvd, Sun City, AZ 85351-3023 | 2020-09-21 |
| 1679904734 | Arizona Neurological Institute, PC | Physical Therapist | 10474 W Thunderbird Blvd, Suite 200, Sun City, AZ 85351-3023 | 2013-11-27 |
| 1174953673 | Amy Beth Cruz | Physical Therapist | 10474 W Thunderbird Blvd, Suite 200, Sun City, AZ 85351-3023 | 2013-11-19 |
| 1508154907 | Ani Research, P.C. | Specialist | 10474 W Thunderbird Blvd, Suite 201, Sun City, AZ 85351-3023 | 2011-07-19 |
| 1164713749 | Brandon Craig Woods | Psychiatry & Neurology | 10474 W Thunderbird Blvd, #200, Sun City, AZ 85351-3023 | 2011-04-29 |
| 1477726933 | Pritish Subhash Pawar | Psychiatry & Neurology | 10474 W Thunderbird Blvd, Suite 200, Sun City, AZ 85351-3023 | 2008-04-05 |
| 1205031093 | Kssrgh Sleep | Clinic/Center | 10474 W Thunderbird Blvd, Suite 200, Sun City, AZ 85351-3023 | 2007-06-20 |
| 1083761126 | Arizona Neurological Institute | Psychiatry & Neurology | 10474 W Thunderbird Blvd, Suite 200, Sun City, AZ 85351-3023 | 2007-01-04 |
| 1669540662 | Arizona Neurological Institute, PC | Pain Medicine | 10474 W Thunderbird Blvd, Suite200, Sun City, AZ 85351-3023 | 2006-11-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003566 | T&h Hearing LLC | Hearing Aid Equipment | 13616 N. 99th Ave., Sun City, AZ 85351 | 2019-09-20 |
| 1881247682 | Amanda M Neri | Physician Assistant | 10401 W. Thunderbird Blvd Md Anderson - Banner Boswell, Sun City, AZ 85351 | 2019-07-20 |
| 1649822313 | Azmed Rehab LLC | Family Medicine | 14281 North Del Webb Blvd, Sun City, AZ 85351 | 2019-07-12 |
| 1982182267 | Akdhc, LLC | Internal Medicine | 10249 W Thunderbird Blvd Ste 100, Sun City, AZ 85351 | 2018-07-30 |
| 1871084814 | Amy Mikulec | Physical Therapist | Banner Physical Therapy and Rehab Boswell, 10503 W Thunderbird Blvd Suite 263a, Sun City, AZ 85351 | 2018-05-25 |
| 1194238345 | Lorie Jo Matthews | Nurse Practitioner | 10494 W Thunderbird Blvd Ste 102, Sun City, AZ 85351 | 2017-11-09 |
| 1184153363 | Susan Jane Hockman | Registered Nurse | 14601 N Delwebb Blvd, Sun City, AZ 85351 | 2017-06-09 |
| 1043769169 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 13203 N 103rd Ave Ste J1&j2, Sun City, AZ 85351 | 2016-09-30 |
| 1033563002 | Vittoria Giovannucci | Technician/Technologist | 10503 W Thunderbird Blvd Ste 101a, Sun City, AZ 85351 | 2016-04-15 |
| 1669858379 | Qui Nguyen | Pharmacist | 10660 Nw Grand Ave, Sun City, AZ 85351 | 2015-08-04 |
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| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548618887 | Christina Marie Figueroa | Clinical Neuropsychologist | 10474 W Thunderbird Blvd Ste 201, Sun City, AZ 85351-3015 | 2016-05-26 |
| 1821135708 | Karla Ann Mueller-schrader | Clinical Neuropsychologist | 10451 W Palmeras Dr, Suite 126c, Sun City, AZ 85373-2011 | 2007-01-31 |
| 1952392755 | Kris E. Kratz | Clinical Neuropsychologist | 10494 W Thunderbird Blvd, Suite 108, Sun City, AZ 85351-3058 | 2005-10-31 |
| 1801401369 | Tamara Fisher | Clinical Neuropsychologist | 10474 W Thunderbird Blvd Ste 201, Sun City, AZ 85351-3015 | 2020-09-11 |
| 1831754050 | Nathan A. Harris | Clinical Neuropsychologist | 10474 W Thunderbird Blvd Ste 201, Sun City, AZ 85351-3015 | 2019-05-02 |
| 1437506490 | Briana Auman | Clinical Neuropsychologist | 10515 W Santa Fe Dr, Sun City, AZ 85351-3020 | 2016-05-19 |
| 1326474180 | Jessica Julia Powell | Clinical Neuropsychologist | 10515 W Santa Fe Dr, Sun City, AZ 85351-3020 | 2013-09-24 |
| 1649412743 | Brian Paul Klinck | Clinical Neuropsychologist | 13640 N 99th Ave, Suite 100, Sun City, AZ 85351 | 2009-04-03 |
| 1124293220 | Sun Health Research Institute | Clinical Neuropsychologist | 10515 W Santa Fe Dr, Sun City, AZ 85351-3020 | 2008-04-29 |
| 1831369396 | Sun Health Research Institute | Clinical Neuropsychologist | 10515 W Santa Fe Dr, Sun City, AZ 85351-3020 | 2008-03-11 |
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| 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.