Nicole Antoinetta Thomas, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704268761 Issued in MI

Practice address

18451 W 12 Mile Rd Ste 200
Lathrup Village, MI 48076-2635

Phone

(248) 827-7612

NPI assigned

Apr 30, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Michigan Medical Associates, PCGroup PAC ID 0244128981, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nthomas1155563@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeast Michigan Medical Associates PC

  • Internal Medicine Physician
  • Lathrup Village, MI
  • NPI 1417001660
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1063076610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18451 W 12 MILE RD STE 200",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762635",
            "telephone_number": "248-827-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18451 W 12 MILE RD STE 200",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762635",
            "telephone_number": "248-827-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "NICOLE",
        "middle_name": "ANTOINETTA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704268761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylvan Point Wellness PLLC
• Synergetic Organizational Consulting LLC
• Raveend C Thabolingam, MD
• Thomas Psychological
• Elissa Rose Thomas, LMT
• Tamela Marie Thomas, RN
• Tiffany Goshatt
• Manhal Wadie Tobia, MD
• Tom Kopsch & Associates,Inc
• Shannon W Tomkie, LMSW

• Family Nurse Practitioner in Lathrup Village, MI
• Providers in Lathrup Village, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.