Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kenneth Theriot, MD

Individual provider Anesthesiology Physician · NPI 1114177664

Dr. Kenneth Theriot, MD is an Anesthesiology in Mesa, Arizona. Graduated from Medical College of Wisconsin in 2007, 19 years ago. Practices with Chandler Anesthesia Consultants LLC, a 68-clinician group and accepts Medicare assignment. Licensed in Arizona and Missouri.

Years since qualifying
19
Trained at
Medical College of Wisconsin
Licensed in
AZ, MO
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4002 E Main St Ste 1
Mesa, AZ 85205-8612
Phone: (480) 324-5421
Fax: (480) 324-5459
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 44415 (AZ)
Anesthesiology Physician Taxonomy 207L00000X · Licence 2008015177 (MO)

Record details

NPI number1114177664
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 21, 2008
Last updated in NPPESMarch 29, 2012
Mailing address18827 E Swan Dr, Queen Creek, AZ 85142-5314

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2007 (19 years in practice)
Group practice Chandler Anesthesia Consultants Llc — 68 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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