John Lamar Thumm, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9569 Issued in MI

Practice address

204 W. State St
Mancelona, MI 49659-0679

Phone

(231) 587-9458

Fax

(231) 587-9071

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

Yes

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194877050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W. STATE ST",
            "city": "MANCELONA",
            "state": "MI",
            "postal_code": "496590679",
            "telephone_number": "231-587-9458",
            "fax_number": "231-587-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W. STATE ST",
            "city": "MANCELONA",
            "state": "MI",
            "postal_code": "496590679",
            "telephone_number": "231-587-9458",
            "fax_number": "231-587-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUMM",
        "first_name": "JOHN",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "9569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mancelona Family Practice
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• Diane Zimmerman-Albosta, RDH

• General Practice Dentistry in Mancelona, MI
• Providers in Mancelona, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.