Thomas John Commerford

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1134085 Issued in MN

Practice address

415 Main St
Pepin, WI 54759

Phone

(612) 998-6006

NPI assigned

Jan 24, 2023

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1528774643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "PEPIN",
            "state": "WI",
            "postal_code": "54759",
            "telephone_number": "612-998-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "PEPIN",
            "state": "WI",
            "postal_code": "54759",
            "telephone_number": "612-998-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMMERFORD",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "1134085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heyde Health System Pepin LLC (Lakeview Residence)
• Steven Harris Johnson, D.D.S.
• Pepin Area School District
• Pepin Emergency Ambulance Service
• Pepin Operator, LLC (Pepin Health and Rehab)

• Registered Nurse in Pepin, WI
• Providers in Pepin, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.