Active NPI
Sean F.C. Thomas, D.C.
- Chiropractor
- Fort Wayne, IN
National Provider Identifier
1215216072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08002580A
- Practice address
- 3158 Mallard Cove LN
Fort Wayne, IN 46804-2882 - Phone
- (260) 341-7458
- NPI assigned
- Aug 11, 2011
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08002580A | IN | Primary |
Addresses
Primary practice location
3158 Mallard Cove LN
Fort Wayne, IN 46804-2882
Mailing address
1204 W Jefferson Blvd
Fort Wayne, IN 46802-4012
Phone (260) 341-7458
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08002580A | IN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313020800000",
"number": "1215216072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468024012",
"telephone_number": "260-341-7458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3158 MALLARD COVE LN",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468042882",
"telephone_number": "260-341-7458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "SEAN",
"middle_name": "F.C.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-11",
"last_updated": "2011-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08002580A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.