Izadora Thamie Theodore
Case Manager/Care Coordinator in Randolph, MA. Individual provider (NPI-1).
NPI number1497554232
StatusActive
Last updated in NPPESMar 12, 2025
Details
- NPI
- 1497554232
- Entity type
- Individual (NPI-1)
- Name
- Izadora Thamie Theodore
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 12, 2025
- Certification date
- Mar 12, 2025
- Last updated
- Mar 12, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
400 N Main StRandolph, MA 02368-4177
Phone 781-885-0277
Mailing address
79 Kennedy RdStoughton, MA 02072-3814
Phone 401-422-9717
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 23 Case Manager/Care Coordinator providers in Randolph · All 1,192 providers in Randolph
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