Tracy Jo Thomas, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704169739 Issued in MI

Practice address

4201 Saint Antoine St
Suite 4C
Detroit, MI 48201-2153

Phone

(313) 745-4755

Fax

(313) 993-0085

NPI assigned

Jun 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tthomas4@direct.dmc.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Halo Medical Group PLLC

  • Cardiovascular Disease Physician
  • Detroit, MI
  • NPI 1811214489
  Medicare reassignment
• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1932149838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE",
            "address_2": "SUITE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061",
            "telephone_number": "313-262-1309",
            "fax_number": "313-262-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "SUITE 4C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4755",
            "fax_number": "313-993-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TRACY",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704169739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanisha Thomas, LLMSSW
• Tanya Terrell Thomas, LMSW, ACSW
• Tateyana Thomas
• Taylor Ajena Thomas
• Tenesia Thomas
• Vasiliki Thomas
• Virdell F Thomas, LMSW,CCS,CAADC,CPC
• Wynona Thomas
• Chanetta Denise Thompkins
• Anita Thompson-Muhammad, MD

• Adult Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.