Individual provider Active NPI

Jill M Thomas, N.P.

  • Nurse Practitioner
  • Marquette, MI
National Provider Identifier
1124079710
Registry record updated Jun 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704222283 Issued in MI
Practice address
580 W College Ave
Hospitalist Office
Marquette, MI 49855-2705
Phone
(906) 225-7433
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704222283 MI Primary

Addresses

Primary practice location

580 W College Ave
Hospitalist Office
Marquette, MI 49855-2705

Mailing address

49 Smith LN
Marquette, MI 49855-9352
Phone (906) 361-5210

Other identifiers 2

IdentifierTypeStateIssuer
5008706020OtherMIBLUE CROSS BLUE SHIELD MI
104854881MedicaidMI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060505000454 MI Practitioner - Nurse Practitioner 5698786630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group Michigan PCGroup PAC ID 9931347879, 42 clinicians

Practice addresses (Care Compare)

850 W Baraga Ave
Marquette, MI 49855-4550
Phone (906) 449-3747

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704222283MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Inpatient Physicians - Michigan, PLLC CurrentSince Jul 5, 2009 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Nurse Practitioner CurrentSince Jul 5, 2009 Accepting new patients
Apogee Medical Group, Michigan, PC CurrentSince Feb 1, 2022 Accepting new patients

Locations

3401 Ludington St
Escanaba, MI 49829
Phone (906) 786-3311

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

580 W College Ave
Ofc
Marquette, MI 49855
Phone (906) 225-7433

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1124079710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 SMITH LN",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498559352",
            "telephone_number": "906-361-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVE",
            "address_2": "HOSPITALIST OFFICE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552705",
            "telephone_number": "906-225-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704222283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "5008706020",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104854881",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.