Individual provider Active NPI

Tiffany Marie-Le Thomas, LPN

  • Licensed Practical Nurse
  • Van Buren TWP, MI
National Provider Identifier
1821845694
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703124740 Issued in MI
Practice address
10041 Endicott St
Van Buren TWP, MI 48111-1281
Phone
(734) 899-0714
NPI assigned
May 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703124740 MI Primary

Addresses

Primary practice location

10041 Endicott St
Van Buren TWP, MI 48111-1281

Mailing address

10041 Endicott St
Van Buren TWP, MI 48111-1281
Phone (734) 899-0714

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

State licenses

LicenseStateTypeSpecialty
4703124740MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1821845694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10041 ENDICOTT ST",
            "city": "VAN BUREN TWP",
            "state": "MI",
            "postal_code": "481111281",
            "telephone_number": "734-899-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10041 ENDICOTT ST",
            "city": "VAN BUREN TWP",
            "state": "MI",
            "postal_code": "481111281",
            "telephone_number": "734-899-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TIFFANY",
        "middle_name": "MARIE-LE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703124740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.