Active NPI
Jeffrey Allen Thome, DO
- Family Medicine Physician
- Hesperia, MI
National Provider Identifier
1215045661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- JT009157
- Practice address
- 78 N Division St
Hesperia, MI 49421-5100 - Phone
- (231) 854-6415
- Fax
- (231) 854-6975
- NPI assigned
- Aug 27, 2006
- Last updated
- Dec 30, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | JT009157 | MI | Primary |
Addresses
Primary practice location
78 N Division St
Hesperia, MI 49421-5100
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3024089 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9157 | MI | MD | General Practice Dentistry |
| JT009157 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hesperia Medical Center | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Hesperia, MI
- NPI 1063535805
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451433600000",
"number": "1215045661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78 N DIVISION ST",
"city": "HESPERIA",
"state": "MI",
"postal_code": "494215100",
"telephone_number": "231-854-6415",
"fax_number": "231-854-6975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOME",
"first_name": "JEFFREY",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-27",
"last_updated": "2015-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "JT009157",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3024089",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hesperia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.