Shad M Thomas, LCSW, MSW, CADC III

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L6915 Issued in OR

Practice address

2200 4TH St
Baker City, OR 97814-2615

Phone

(541) 573-7303

Fax

(541) 573-5938

NPI assigned

Dec 30, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1013287507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 138",
            "city": "BURNS",
            "state": "OR",
            "postal_code": "977200138",
            "telephone_number": "541-573-7303",
            "fax_number": "541-573-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 4TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978142615",
            "telephone_number": "541-573-7303",
            "fax_number": "541-573-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SHAD",
        "middle_name": "M",
        "credential": "LCSW, MSW, CADC III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-30",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "16-01-16",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090450",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCD",
            "identifier": "500666423",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chaofen Tan, PHARM.D.
• Curtis F Tatlock, L.D.
• Melanie Taylor Taylor/Heideman, CNA
• Micah Thayn, PAC
• Jason Thedsombandith
• Trevor Ray Thompson
• Wendy Thorne
• Shannon Thornton, BS
• Tory Michael Thornton, FNP
• Thrifty Payless Inc

• Clinical Social Worker in Baker City, OR
• Providers in Baker City, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.