NPIMap

Individual provider Active NPI

Mikal Ann Thoren

  • Speech-Language Pathologist
  • Gillette, WY
National Provider Identifier
1295393361
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-964 Issued in WY
Practice address
1801 S 4J Rd
Gillette, WY 82718-5201
Phone
(307) 682-2392
NPI assigned
Jun 3, 2019
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP-964 WY Primary

Addresses

Primary practice location

1801 S 4J Rd
Gillette, WY 82718-5201

Mailing address

1801 S 4J Rd
Gillette, WY 82718-5201
Phone (307) 682-2392

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Pain Management of Wyoming, LLC Past Accepting new patients
Children's Developmental Services of Campbell County Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1295393361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 S 4J RD",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827185201",
            "telephone_number": "307-682-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S 4J RD",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827185201",
            "telephone_number": "307-682-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOREN",
        "first_name": "MIKAL",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WY",
            "license": "SP-964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.