MR. THEODORE HOWARD VINEYARD NP NPI 1689954091

NPI Information

  • NPI: 1689954091
  • Provider Name: MR. THEODORE HOWARD VINEYARD, NP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 601 ELMWOOD AVE
    BOX SURG 8-3600
    ROCHESTER, NY
    ZIP 14642
  • Phone: (585) 275-2113

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NPI Details

MR. Theodore Howard Vineyard, NP is an adult health nurse practitioner in Rochester, NY with 14 years of experience. MR. Theodore Howard Vineyard, NP NPI is 1689954091. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 ELMWOOD AVE
BOX SURG 8-3600
ROCHESTER, NY
ZIP 14642-001
Phone: (585) 275-2113

The NPI 1689954091 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/17/2011 and was last updated on 7/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2100XNurse PractitionerAcute Care305756NEW YORKNo
2363LA2200XNurse PractitionerAdult HealthF305756-1NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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