Active NPI
Laura Elizabeth Thomas
- Athletic Trainer
- Wyoming, MI
National Provider Identifier
1760966964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 5722 Metro Way SW Ste B
Wyoming, MI 49519-9524 - Phone
- (616) 252-6034
- NPI assigned
- Sep 24, 2018
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
5722 Metro Way SW Ste B
Wyoming, MI 49519-9524
Mailing address
59617 Silvergrass Drive
Mattawan, MI 49071
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000000000000000000 | Other | MI | BCBS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537747200000",
"number": "1760966964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59617 SILVERGRASS DRIVE",
"city": "MATTAWAN",
"state": "MI",
"postal_code": "49071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5722 METRO WAY SW STE B",
"city": "WYOMING",
"state": "MI",
"postal_code": "495199524",
"telephone_number": "616-252-6034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "LAURA",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-24",
"last_updated": "2018-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00000000000000000000",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.