Individual provider Active NPI

Thomas Laclair, DPT, CSCS

  • Physical Therapist
  • Dewitt, MI
National Provider Identifier
1457809196
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017916 Issued in MI
Practice address
1161 E Clark Rd
156
Dewitt, MI 48820-7930
Phone
(517) 668-0000
NPI assigned
Sep 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501017916 MI Primary

Addresses

Primary practice location

1161 E Clark Rd
156
Dewitt, MI 48820-7930

Mailing address

1161 E Clark Rd
156
Dewitt, MI 48820-7930
Phone (810) 441-2185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161004002797 MI Practitioner - Physical Therapist in Private Practice 7416245691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Physical Therapy Connection, Inc.Group PAC ID 0042399552, 5 clinicians

Practice addresses (Care Compare)

1161 E Clark Rd
Suite 156
Dewitt, MI 48820-8312

13575 S Airport Rd
Suite 105
Lansing, MI 48906-9187
Phone (517) 668-0000

15990 S US Hwy 27
Lansing, MI 48906-1493
Phone (517) 668-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Connection LLC Physical Therapist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1457809196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 E CLARK RD",
            "address_2": "156",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207930",
            "telephone_number": "810-441-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 E CLARK RD",
            "address_2": "156",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207930",
            "telephone_number": "517-668-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACLAIR",
        "first_name": "THOMAS",
        "credential": "DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dewitt, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.