Individual provider Active NPI

Jennifer Lynn Thomison, D.T.

  • Specialist
  • Le Roy, IL
National Provider Identifier
1366624637
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
411 E Elm St
Le Roy, IL 61752-1535
Phone
(309) 868-1793
Fax
(309) 962-3270
NPI assigned
Nov 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

411 E Elm St
Le Roy, IL 61752-1535

Mailing address

411 E Elm St
Le Roy, IL 61752-1535
Phone (309) 868-1793

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

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1366624637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E ELM ST",
            "city": "LE ROY",
            "state": "IL",
            "postal_code": "617521535",
            "telephone_number": "309-868-1793",
            "fax_number": "309-962-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E ELM ST",
            "city": "LE ROY",
            "state": "IL",
            "postal_code": "617521535",
            "telephone_number": "309-868-1793",
            "fax_number": "309-962-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMISON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "D.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Roy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.