Individual provider Active NPI

Betsy Thomas, PA-C

  • Physician Assistant
  • Clinton Township, MI
National Provider Identifier
1366957136
Registry record updated Dec 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008483 Issued in MI
Practice address
15945 19 Mile Rd Ste 202
Clinton Township, MI 48038-1147
Phone
(586) 286-7246
NPI assigned
Dec 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008483 MI Primary

Addresses

Primary practice location

15945 19 Mile Rd Ste 202
Clinton Township, MI 48038-1147

Mailing address

1103 Ridgeway Dr
Rochester, MI 48307-1772

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
5601008483MIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: bthomas563116@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1512259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512259200000",
    "number": "1366957136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 RIDGEWAY DR",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 19 MILE RD STE 202",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381147",
            "telephone_number": "586-286-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "BETSY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-03",
        "last_updated": "2017-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.