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MARK THEODORE FNP-BC
NPI 1457793135
Nurse Practitioner - Family in Utica, NY

Active since July 23, 2013
1656 CHAMPLIN AVE, UTICA, NY 13502(315) 624-6000 Get Directions Write a Review

NPPES record last updated: July 23, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mark Theodore Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK THEODORE FNP-BC (NPI 1457793135) is an individual family provider in Utica, New York, licensed in New York (338083) and active in the NPI registry since July 2013.

NPPES Registry Identity

NPI1457793135
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMARK THEODORECredential: FNP-BC
Location Address1656 CHAMPLIN AVEUtica, NY 13502-4830
Mailing Address1656 Champlin AveUtica, NY 13502-4830 · (315) 624-6000
Phone(315) 624-6000
Sole ProprietorYes
Enumeration DateJuly 23, 2013
✔ NPI 1457793135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 338083
Also ListedRegistered Nurse · Critical Care MedicineTaxonomy 163WC0200X · License 629932 (NY)
1656 CHAMPLIN AVE, Utica, NY 13502
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN F SPERLING M.D.
Surgery
1656 CHAMPLIN AVE, P.O.B., SUITE 335
UTICA, NY 13502
Oneida County (315) 624-4090
MR. TRACY S HEATON R.PH,
Pharmacist
1656 CHAMPLIN AVE
UTICA, NY 13502
Oneida County (315) 624-6010
CATHERINE M VANNICOLA
Nurse Practitioner
1656 CHAMPLIN AVE
UTICA, NY 13502
Oneida County (315) 525-2448
LYNDSY DAVIS CCC-SLP
Speech-Language Pathologist
1656 CHAMPLIN AVE
UTICA, NY 13502
Oneida County (315) 624-6557
SEAN PHILLIPS PA-C
Physician Assistant
1656 CHAMPLIN AVE
UTICA, NY 13502
Oneida County (315) 624-6068
DR. PARU SHAH
Dentist
1656 CHAMPLIN AVE
UTICA, NY 13502
Oneida County (315) 734-0541
KRISTINA DUCHMANN MSW-LICENSED
Social Worker
1656 CHAMPLIN AVE
UTICA, NY 13502
Oneida County (315) 801-8135
RAQUEL BARBIERI MD
Student in an Organized Health Care Education/Training Program
1656 CHAMPLIN AVE
UTICA, NY 13502
Oneida County (315) 624-6829

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Theodore's NPI number?

The NPI number for Mark Theodore is 1457793135. It was assigned to this individual provider in the NPPES registry on July 23, 2013.

Where is Mark Theodore located?

Mark Theodore practices at 1656 Champlin Ave, Utica, NY 13502. The listed phone number is (315) 624-6000.

What is Mark Theodore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Mark Theodore was last updated on July 23, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.