Individual provider Active NPI

Cheryl Thomas, MS, CGC

  • Genetic Counselor (M.S.)
  • St Petersburg, FL
National Provider Identifier
1710548938
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
1116 Issued in MN
Practice address
877 Executive Center Dr W Ste 206
St Petersburg, FL 33702-2472
Phone
(760) 407-2477
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X 1116 MN Primary

Addresses

Primary practice location

877 Executive Center Dr W Ste 206
St Petersburg, FL 33702-2472

Mailing address

405 13TH Ave NW
Rochester, MN 55901-1810
Phone (507) 269-8854

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1116MNMDGenetic Counselor (M.S.)

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1710548938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 13TH AVE NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011810",
            "telephone_number": "507-269-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 EXECUTIVE CENTER DR W STE 206",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022472",
            "telephone_number": "760-407-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CHERYL",
        "credential": "MS, CGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "MN",
            "license": "1116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.