Individual provider Active NPI

Thompson U Ejiofor

  • Driver
  • Niles, MI
National Provider Identifier
1063851905
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
325 Erin Dr
Niles, MI 49120-1425
Phone
(269) 684-0632
Fax
(269) 684-0632
NPI assigned
Jun 24, 2013
Last updated
Jun 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X MI Primary

Addresses

Primary practice location

325 Erin Dr
Niles, MI 49120-1425

Mailing address

325 Erin Dr
Niles, MI 49120-1425
Phone (269) 684-0632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1063851905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 ERIN DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491201425",
            "telephone_number": "269-684-0632",
            "fax_number": "269-684-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 ERIN DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491201425",
            "telephone_number": "269-684-0632",
            "fax_number": "269-684-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJIOFOR",
        "first_name": "THOMPSON",
        "middle_name": "U",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.