Individual Healthcare Provider
Jeremy Theisen, MD
Provider's NPPES record last updated: September 23, 2025
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1881954501
- Primary Specialty
- Radiology — Diagnostic Radiology
- Practice Location
- Ponca City, Oklahoma
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 20, 2026, 2:20 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Radiology
Diagnostic Radiology
Allopathic & Osteopathic Physicians
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Taxonomy code 2085R0202X Internal Medicine
Allopathic & Osteopathic Physicians
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Taxonomy code 207R00000X
Provider-Reported License Information
- Radiology (Oklahoma)
- 29296
- Radiology (Hawaii)
- MD-23144
- Internal Medicine (Oklahoma)
- 29296
- Radiology (New Jersey)
- 25IA12501900
Practice Locations
Practice Location
1900 N 14th St
Ponca City, Oklahoma 74601-2035
Phone: (580) 765-0575
Additional Practice Location
920 Sl Young Blvd
Oklahoma City, Oklahoma 73104-5036
Phone: (405) 271-5963
Additional Practice Location
920 Sl Young Blvd
Oklahoma City, Oklahoma 73104-5036
Phone: (405) 271-5963
Additional Practice Location
750 Brunswick Ave
Trenton, New Jersey 08638-4143
Phone: (609) 394-6000
Additional Practice Location
1 Capital Way
Pennington, New Jersey 08534-2520
Phone: (609) 303-4000
Additional Practice Location
310 Salem Woodstown Rd
Salem, New Jersey 08079-2064
Phone: (856) 339-6054
Fax: (856) 935-6714
Record Information
- Enumeration Date
- May 29, 2012
- Provider's NPPES Record Last Updated
- September 23, 2025
- Certification Date
- September 23, 2025
- NPISignal NPPES Dataset
- August 2026
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