Jason Theodore
Jason Theodore is a Physician Assistant in Lincoln, Nebraska. Qualified in 2019, 7 years ago. Practices with Freedom House Recovery Center Inc, a 13-clinician group and accepts Medicare assignment.
- Years since qualifying
- 7
- In the registry since
- 2019
Practice location Address checks out
4615 Meredeth St Apt 6Lincoln, NE 68506-4973
Phone: (347) 449-1387
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1629535521 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 27, 2019 |
| Last updated in NPPES | September 9, 2019 |
| Mailing address | 4615 Meredeth St Apt 6, Lincoln, NE 68506-4973 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2019 (7 years in practice) |
| Group practice | Freedom House Recovery Center Inc — 13 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 7 on file with Medicare |
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