Active NPI
Elizabeth Michelle Thomas
- Community Health Worker
- Milwaukee, WI
National Provider Identifier
1669702460
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Feb 20, 2013.
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- T5202337672209
- Practice address
- 3721 W Garfield Ave
Milwaukee, WI 53208-1343 - Phone
- (414) 712-5770
- NPI assigned
- Dec 30, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | T5202337672209 | WI | Primary |
Addresses
Primary practice location
3721 W Garfield Ave
Milwaukee, WI 53208-1343
Mailing address
3721 W Garfield Ave
Milwaukee, WI 53208-1343
Phone (414) 712-5770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T5202337672209 | WI | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262131200000",
"number": "1669702460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3721 W GARFIELD AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532081343",
"telephone_number": "414-712-5770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3721 W GARFIELD AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532081343",
"telephone_number": "414-712-5770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "ELIZABETH",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-30",
"last_updated": "2009-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "WI",
"license": "T5202337672209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.