Active NPI
Thaddeus Michael Norris, MD
- Family Medicine Physician
- Garden City, ID
National Provider Identifier
1841267747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MV-0023
- Practice address
- 215 W 35TH St
Garden City, ID 83714-6520 - Phone
- (503) 704-2415
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MV-0023 | IL | Primary |
Addresses
Primary practice location
215 W 35TH St
Garden City, ID 83714-6520
Mailing address
2000 S Myers St
Boise, ID 83706-4008
Phone (503) 704-1415
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MV-0023 | Other | ID | MEDICAL LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MV-0023 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677110400000",
"number": "1841267747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 S MYERS ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837064008",
"telephone_number": "503-704-1415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W 35TH ST",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "837146520",
"telephone_number": "503-704-2415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORRIS",
"first_name": "THADDEUS",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2023-02-23",
"certification_date": "2023-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "MV-0023",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "MV-0023",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garden City, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.