Active NPI
David Thatch, MT
- Medical Technologist
- Fort Washakie, WY
National Provider Identifier
1205235330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- Practice address
- 29 Black Coal Drive
Fort Washakie, WY 82514 - Phone
- (307) 332-7300
- Fax
- (307) 332-7514
- NPI assigned
- Aug 14, 2014
- Last updated
- Aug 14, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | Primary |
Addresses
Primary practice location
29 Black Coal Drive
Fort Washakie, WY 82514
Mailing address
29 Black Coal Dr
Ft. Washakie, WY 82514
Phone (307) 332-7300
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
- Credentials
- Medical Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1205235330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 BLACK COAL DR",
"city": "FT. WASHAKIE",
"state": "WY",
"postal_code": "82514",
"telephone_number": "307-332-7300",
"fax_number": "307-332-7514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BLACK COAL DRIVE",
"city": "FORT WASHAKIE",
"state": "WY",
"postal_code": "82514",
"telephone_number": "307-332-7300",
"fax_number": "307-332-7514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THATCH",
"first_name": "DAVID",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-14",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Washakie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.