Michael Robert Berg Thayer

Primary specialty

Intermediate Emergency Medical TechnicianTaxonomy code 146M00000X

License

A2008424

Practice address

Madigan Army Medical Center 9040Jackson Ave
Attn: MCHJ-CLQ-C
Tacoma, WA 98431-1100

Phone

(253) 968-1110

NPI assigned

Feb 2, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1356889976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040JACKSON AVE",
            "address_2": "ATTN: MCHJ-CLQ-C",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040JACKSON AVE",
            "address_2": "ATTN: MCHJ-CLQ-C",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT BERG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": null,
            "license": "A2008424",
            "primary": true
        },
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "MT",
            "license": "MED-AEMT-LIC-40939",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intermediate Emergency Medical Technician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Intermediate Emergency Medical Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.