Individual provider Active NPI

Christy Marie Thallman, MSN RN FNP

  • Nurse Practitioner
  • Pontiac, MI
National Provider Identifier
1649245010
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704203244 Issued in MI
Practice address
1200 N Telegraph Rd
BLDG. 32E
Pontiac, MI 48341-1032
Phone
(734) 464-0887
Fax
(734) 402-0254
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704203244 MI Primary

Addresses

Primary practice location

1200 N Telegraph Rd
BLDG. 32E
Pontiac, MI 48341-1032

Mailing address

36123 Schoolcraft Rd
Livonia, MI 48150-1216
Phone (734) 464-0887

Other identifiers 3

IdentifierTypeStateIssuer
0N82760002OtherMIMEDICARE
0N82770003OtherMIMEDICARE
500F318890OtherMIBCBS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040303000647 MI Practitioner - Nurse Practitioner 2961399902 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Post-Acute Medical Services 1 PCGroup PAC ID 2163798877, 25 clinicians
Mi Pacs 2 PCGroup PAC ID 2264831577, 18 clinicians

Practice addresses (Care Compare)

1014 E Grand River Ave
Brighton, MI 48116-1804
Phone (810) 220-5222

202 S Bridge St
Linden, MI 48451-8805
Phone (810) 735-9500

22600 W Main St
Armada, MI 48005-3237
Phone (734) 508-4569

625 36TH St SW
Wyoming, MI 49509-4004
Phone (616) 531-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Midwest LLC CurrentSince Oct 21, 2024 Accepting new patients
Mi Pacs 2 PC CurrentSince Jun 1, 2021 Accepting new patients
Inpatient Consultants of Michigan PC CurrentSince May 26, 2010 Accepting new patients
Michigan Post-Acute Medical Services 1 PC CurrentSince Sep 11, 2017 Accepting new patients
Traveling Medical Services PC Nurse Practitioner PastSince Mar 13, 2022 Accepting new patients
Mary E Barna DPM & Associates PC PastSince Mar 13, 2022 Accepting new patients

Locations

22600 W Main St
Armada, MI 48005
Phone (734) 508-4569

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

23550 Haggerty Rd
Farmington Hills, MI 48335
Phone (248) 381-8081

G3201 Beecher Rd
Flint, MI 48532
Phone (810) 732-9200

12200 Broadbent Rd
Lansing, MI 48917
Phone (517) 731-6200

36123 Schoolcraft Rd
Livonia, MI 48150
Phone (734) 793-6140

555 Highland Ave
Milford, MI 48381
Phone (248) 684-1564

3310 W Commerce Rd
Milford, MI 48380
Phone (248) 685-1400

1211 Stateline Rd
Niles, MI 49120
Phone (269) 684-2810

1200 N Telegraph Rd
Bldg 32E
Pontiac, MI 48341
Phone (248) 451-2600

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

6827 Whitehall Rd
Whitehall, MI 49461
Phone (231) 893-8730

625 36th St SW
Wyoming, MI 49509
Phone (517) 481-3715

Organizations & group practices 6

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1649245010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N TELEGRAPH RD",
            "address_2": "BLDG. 32E",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411032",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THALLMAN",
        "first_name": "CHRISTY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN RN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704203244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0N82760002",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0N82770003",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "500F318890",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.