Rout Thac

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

3031899 Issued in AZ

Practice address

4911 W Maldonado Rd
Laveen, AZ 85339-8217

Phone

(480) 275-1056

NPI assigned

Feb 2, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1477259356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 W MALDONADO RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853398217",
            "telephone_number": "480-275-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 W MALDONADO RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853398217",
            "telephone_number": "480-275-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAC",
        "first_name": "ROUT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "SLH10481",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AZ",
            "license": "3031899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alphonso Taylor
• Anu Tazi, PHARMD
• Derek Tea
• Teri'S Health Services
• Tesfaye Tesema
• Sherilyn Thac
• The Armstead Group LLC
• The Family House, LLC
• Therapro Physical Therapy Services, LLC
• Thielen Dental LLC

• Non-emergency Medical Transport (VAN) in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Non-emergency Medical Transport (VAN) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.