Mayly Thor, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1930 Issued in MN

Practice address

6200 Shingle Creek Pkwy Ste 250
Brooklyn Center, MN 55430-2107

Phone

(763) 299-6431

NPI assigned

Dec 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Pediatric Dentistry
  • Minneapolis, MN
  • NPI 1700932449
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Ilbnc, P.a.

  • Orthopaedic Surgery of the Spine Physician
  • Bloomington, MN
  • NPI 1023001815
  NPD (past)

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1487367017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2446 PASCAL ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133124",
            "telephone_number": "612-247-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SHINGLE CREEK PKWY STE 250",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302107",
            "telephone_number": "763-299-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOR",
        "first_name": "MAYLY",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-28",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "1930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew J. Thompson, MSW, LICSW
• Aree Thompson, RN
• Lily Ann Thompson, MD
• Michelle Thompson
• Amanda Thor
• Josephine Thorman
• Gabriella Claire Thull
• Patricia Kathleen Thurmer, MSW, LICSW
• Barbara Ann Tjepkes, WHNP
• TLC Healthcare SVS,LLC

• Registered Dietitian in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.