REBECCA L THORESON (NPI# 1477762441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477762441 |
| Entity Type | Individual |
| Full Name | REBECCA L THORESON |
| Credential | M.D. |
| Practice Address |
404 Hazen St Suite 101 Paw Paw MI 49079-1040 |
| Mailing Address |
601 John St Suite 101 Kalamazoo MI 49007-5341 |
| Practice Telephone | 2696574407 |
| Practice Fax Number | 2696570965 |
| Mailing Telephone | 2696574407 |
| Mailing Fax Number | 2696570965 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2014-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | R7645 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS M - BLH | 1235131137 | 01 |
| MI | BCBSM - BLH TAX ID | 1235131137 | 01 |
| MI | 1477762441 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396053765 | Rebecca R Thoreson | Nurse Practitioner | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2010-09-20 |
| Street Address |
404 HAZEN ST SUITE 101 |
| City | PAW PAW |
| State | MI |
| Zip Code | 49079-1040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437159597 | Nadeem M Mirza | Psychiatry & Neurology | 404 Hazen St, Suite 104, Paw Paw, MI 49079-1040 | 2005-07-29 |
| 1346510252 | Lisa Rae Woodruff | Nurse Practitioner | 404 Hazen St, Suite L3, Paw Paw, MI 49079-1040 | 2012-01-09 |
| 1639313174 | Bronson Lakeview Hospital | Psychologist | 404 Hazen St, Suite L3, Paw Paw, MI 49079-1040 | 2009-04-28 |
| 1265656086 | Lakeview Community Hospital Authority | Surgery | 404 Hazen St, Suite 101, Paw Paw, MI 49079-1040 | 2007-04-12 |
| 1881706273 | Michael Kruk | Social Worker | 404 Hazen St, Suite L3, Paw Paw, MI 49079-1040 | 2006-08-31 |
| 1427161314 | Barbara L Thompson | Pharmacist | 404 Hazen St, Suite 102, Paw Paw, MI 49079-1040 | 2006-08-16 |
| 1710090519 | Jennifer L Sampsell | Pharmacy Technician | 404 Hazen St, Suite 102, Paw Paw, MI 49079-1040 | 2006-08-16 |
| 1376554881 | Skinner & Hang Inc | Pharmacy | 404 Hazen St, Suite 102, Paw Paw, MI 49079-1040 | 2006-08-10 |
| 1043228174 | Patrick Michael Lynch | Pharmacist | 404 Hazen St, Suite 102, Paw Paw, MI 49079-1040 | 2006-08-04 |
| 1104845239 | Paul Stephen Costanzo | Physician Assistant | 404 Hazen St, Suite L3, Paw Paw, MI 49079-1040 | 2006-07-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700359387 | Elizabeth Ann Heskett | Social Worker | Bronson Lakeview Family Care, 451 Health Parkway, Suite B, Paw Paw, MI 49079 | 2019-01-07 |
| 1346775269 | Timothy Adli Kanaan | Counselor | 816 E Michigan Ave Ste 103, Paw Paw, MI 49079 | 2017-04-28 |
| 1558655464 | Tamayi Bwititi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2011-06-08 |
| 1942401047 | Jenny Adina Grunberg | Dentist | 54055 County Rd 653, Paw Paw, MI 49079 | 2007-05-29 |
| 1912058918 | David James Potts | Psychologist | 181 West Michigan Ave Suite 3, Mapleview Consultation Center P.c, Paw Paw, MI 49079 | 2007-01-16 |
| 1760438378 | Starhealth Multi-specialty Group, P.C. Pharmacy | Pharmacist | 451 Health Parkway, Paw Paw, MI 49079 | 2006-05-25 |
| 1528029568 | Jayantilal J Bathani | Pediatrics | 505 Hazen St, Ste 203, Paw Paw, MI 49079 | 2006-03-29 |
| 1548231202 | Gregory Cassidy | Physician Assistant | 125 N Kalamazoo St, #82, Paw Paw, MI 49079 | 2006-01-31 |
| 1649782418 | Amber Bemis | Occupational Therapy Assistant | 801 Hazen Street, Suite C, Paw Paw, MI 49079 | 2017-11-01 |
| 1073047122 | Theresa Arnold | Social Worker | 181 W Michigan Ave Ste 3, Paw Paw, MI 49079 | 2017-04-15 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649411539 | Lisa Marie Gray | Surgery | 404 Hazen, Suite 101, Paw Paw, MI 49079-1040 | 2009-03-23 |
| 1265656086 | Lakeview Community Hospital Authority | Surgery | 404 Hazen St, Suite 101, Paw Paw, MI 49079-1040 | 2007-04-12 |
| 1861479891 | Eui-dong Lee | Surgery | 404 Hazen St, Suite 101, Paw Paw, MI 49079-1040 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508475237 | Dr Dayhim Pllc | Surgery | 12203 Shearwater Cir, Commerce Township, MI 48390-4260 | 2020-07-28 |
| 1922624923 | Dr Anthony Joseph Md Pllc | Surgery | 2330 S Milford Rd Ste 120, Highland, MI 48357-4982 | 2020-06-25 |
| 1316563646 | Shelley Gabel | Surgery | 1200 E Michigan Ave., Sparrow Professional Building Suite 655, Lansing, MI 48912 | 2020-06-23 |
| 1922623081 | Joon B Kim | Surgery | 1200 Michigan Ave Ste 655, East Lansing, MI 48823-4099 | 2020-06-14 |
| 1932724101 | Alec Jerry Raniwsky | Surgery | 22250 Providence Drive 7pmb Suite #703a, Southfield, MI 48075-4825 | 2020-06-12 |
| 1184245771 | Upper Michigan Associates LLC | Surgery | 1414 W Fair Ave Ste 235, Marquette, MI 49855-5406 | 2020-05-05 |
| 1245851427 | Adriana Sharp | Surgery | 1 Genesys, Grand Blanc, MI 48439 | 2020-04-29 |
| 1487275509 | Erika C Michelin | Surgery | 28080 Grand River Ave Ste 208, Farmington Hills, MI 48336-5966 | 2020-04-29 |
| 1063047629 | Suzanne A. Law, D.o., P.C. | Surgery | G4007 W Court St Ste E, Flint, MI 48532-3560 | 2020-03-04 |
| 1801454871 | Dakita Mack | Surgery | 28050 Grand River Ave Ste 208n, Farmington Hills, MI 48336-5919 | 2019-06-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.