DR. VICTORIA HARRIS THEDFORD (NPI# 1730235771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730235771 |
| Entity Type | Individual |
| Full Name | DR. VICTORIA HARRIS THEDFORD |
| Credential | M.D. |
| Practice Address |
155 Medical Way Ste E Riverdale GA 30274 |
| Mailing Address |
Po Box 783 Rex GA 30273-0783 |
| Practice Telephone | 7709681997 |
| Practice Fax Number | 7709681918 |
| Mailing Telephone | 7709681997 |
| Mailing Fax Number | 7709681918 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2018-07-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 054039 | GA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 054039 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 187347049E | 05 |
| Street Address |
155 MEDICAL WAY STE E |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821265646 | Sikira Chantal Backus | Pediatrics | 6103 Baltimore Ave Ste T1, Riverdale, MD 20737-1966 | 2008-05-12 |
| 1922140946 | Sonea Qureshi | Pediatrics | 3567 W. Mt. Whitney Ave., Riverdale, CA 93656 | 2007-02-13 |
| 1578664827 | Sook Hee Ahn | Pediatrics | 251 Medical Way, Suite A, Riverdale, GA 30274-2522 | 2006-09-26 |
| 1821193046 | Adrene Sellers-scott | Pediatrics | 150 Medical Way Ste B1, Riverdale, GA 30274-2533 | 2006-09-13 |
| 1780618637 | Subramanyam P Reddy | Pediatrics | 253 Upper Riverdale Rd, Ste A, Riverdale, GA 30274 | 2006-07-10 |
| 1801859830 | Kimberly J Winzer Md PC | Pediatrics | 6524 Professional Pl, Riverdale, GA 30274-2520 | 2006-04-10 |
| 1174043236 | Misha Capri Purnell | Pediatrics | 6103 Baltimore Ave Ste T1, Riverdale, MD 20737-1966 | 2017-06-21 |
| 1407217243 | Herberth Marcelo Ochoa Flores | Pediatrics | 6103 Baltimore Ave Ste T1, Riverdale, MD 20737-1966 | 2016-03-07 |
| 1013386846 | Riverdale Park Pediatrics PC | Pediatrics | 6103 Baltimore Ave, Suite T-1, Riverdale, MD 20737-1966 | 2015-09-23 |
| 1538544754 | Lourdes Gonzalez Aviles | Pediatrics | 6103 Baltimore Ave Ste T1, Riverdale, MD 20737 | 2015-07-29 |
| Find all providers in RIVERDALE | ||||
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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.