Thomas Gordon Wayne, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301047530 Issued in MI

Practice address

4150 S River Rd
Ste F1
East China, MI 48054

Phone

(810) 326-0858

Fax

(810) 326-0933

NPI assigned

Jul 25, 2006

Last updated

Sep 30, 2020By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Thomas G. Wayne M.D., P.L.L.C.

  • Family Medicine Physician
  • East China, MI
  • NPI 1508167206
  Authorized official Same address or phone

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1861415754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 S RIVER RD",
            "address_2": "STE F1",
            "city": "EAST CHINA",
            "state": "MI",
            "postal_code": "48054",
            "telephone_number": "810-326-0858",
            "fax_number": "810-326-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 S RIVER RD",
            "address_2": "STE F1",
            "city": "EAST CHINA",
            "state": "MI",
            "postal_code": "48054",
            "telephone_number": "810-326-0858",
            "fax_number": "810-326-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYNE",
        "first_name": "THOMAS",
        "middle_name": "GORDON",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301047530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0807408272",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4277711",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Elizabeth Tomaszewski, NURSE PRACTITIONER
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• Pattiann Vantreese, CRNA
• Kimberly A Vono
• Trisha Vore
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• Jessica Lynn Young, PA-C
• Cory D Zieger, MD
• John J Zmiejko, M.D.

• Family Medicine Physician in East China, MI
• Providers in East China, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.