Individual provider Active NPI

Thomas J McGuire, MD

  • Internal Medicine Physician
  • Canon City, CO
National Provider Identifier
1356351969
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31790 Issued in CO
Practice address
614 Yale PL
Canon City, CO 81212
Phone
(719) 275-5751
Fax
(719) 269-7033
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31790 CO Primary

Addresses

Primary practice location

614 Yale PL
Canon City, CO 81212

Mailing address

614 Yale PL
Canon City, CO 81212
Phone (719) 275-5751

Other identifiers 1

IdentifierTypeStateIssuer
01317908MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050131000124 CO Practitioner - Internal Medicine 7719877901 Practice locations: Canon City, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31790COMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1356351969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 YALE PL",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "81212",
            "telephone_number": "719-275-5751",
            "fax_number": "719-269-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 YALE PL",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "81212",
            "telephone_number": "719-275-5751",
            "fax_number": "719-269-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "31790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01317908",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.