Michael R Thomas, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D10593 Issued in MN

Practice address

1511 Carlson Street
Marshall, MN 56258-2605

Phone

(507) 532-3353

Fax

(507) 532-3482

NPI assigned

Jul 21, 2006

Last updated

Apr 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael R Thomas DDS

  • Dentist
  • Marshall, MN
  • NPI 1073745725
  NPD (past) Authorized official

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1700807328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 CARLSON ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582626",
            "telephone_number": "507-532-3353",
            "fax_number": "507-532-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 CARLSON STREET",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582605",
            "telephone_number": "507-532-3353",
            "fax_number": "507-532-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS",
            "identifier": "836189",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IN",
            "identifier": "0B12TH",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "834222900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jeffrey Ray Thomas, DDS
• Nathaniel Erik Thomsen, PTA
• Jill Marie Thooft, RDA
• Jana Michelle Timmerman, BS
• Stacey Tischer, PHARMD
• Kelsey L Tollefson, MSW, LICSW

• Dentist in Marshall, MN
• Providers in Marshall, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.