Individual provider Active NPI

Deborah G Thistle

  • Developmental Therapist
  • Avon, IN
National Provider Identifier
1295043040
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
1069728 Issued in IN
Practice address
7641 Monteray Cir
Avon, IN 46123-7795
Phone
(317) 319-6011
NPI assigned
Sep 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X 1069728 IN Primary

Addresses

Primary practice location

7641 Monteray Cir
Avon, IN 46123-7795

Mailing address

7641 Monteray Cir
Avon, IN 46123-7795
Phone (317) 319-6011

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

State licenses

LicenseStateTypeSpecialty
1069728INMDDevelopmental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1295043040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7641 MONTERAY CIR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237795",
            "telephone_number": "317-319-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7641 MONTERAY CIR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237795",
            "telephone_number": "317-319-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THISTLE",
        "first_name": "DEBORAH",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IN",
            "license": "1069728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.