Individual provider Active NPI

Modina Richia Thrasher, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Livonia, MI
National Provider Identifier
1497876767
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301053689 Issued in MI
Practice address
32355 Capitol
Laboratory Corporation of America
Livonia, MI 48150
Phone
(734) 573-3500
Fax
(734) 524-9316
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301053689 MI Primary

Addresses

Primary practice location

32355 Capitol
Laboratory Corporation of America
Livonia, MI 48150

Mailing address

32355 Capitol
Livonia, MI 48150
Phone (734) 573-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140726000079 MI Practitioner - Pathology 1658597778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Wayne State University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1215 E Michigan Ave
SMG Adult Critical Care
Lansing, MI 48912-1811
Phone (517) 364-4340

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301053689MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Jun 1, 2014 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Jun 1, 2014 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497876767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32355 CAPITOL",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48150",
            "telephone_number": "734-573-3500",
            "fax_number": "734-524-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32355 CAPITOL",
            "address_2": "LABORATORY CORPORATION OF AMERICA",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48150",
            "telephone_number": "734-573-3500",
            "fax_number": "734-524-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THRASHER",
        "first_name": "MODINA",
        "middle_name": "RICHIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301053689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.