Individual provider Active NPI

Damon J Thomas, M.D.

  • Family Medicine Physician
  • Crane, MO
National Provider Identifier
1023100773
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
113023 Issued in MO
Practice address
102 Cortney LN
Crane, MO 65633-9192
Phone
(417) 269-2264
Fax
(417) 269-2270
NPI assigned
Sep 29, 2006
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 113023 MO Primary

Addresses

Primary practice location

102 Cortney LN
Crane, MO 65633-9192

Mailing address

PO Box 505673
Saint Louis, MO 63150-5673
Phone (417) 730-6430

Other identifiers 1

IdentifierTypeStateIssuer
205040108MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100206000156 MO Practitioner - Family Practice 0345383782

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.85 of 100Reported as group
Quality
63.56
Promoting interoperability
100
Improvement activities
40
Cost
72.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Apr 27, 2011 Accepting new patients
Lester E. Cox Medical Centers Family Medicine Current Accepting new patients
Lester E Cox Medical Centers Family Medicine CurrentSince Apr 27, 2011 Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

3203 E Old Stone Ave
Brookline, MO 65619
Phone (417) 269-1910

102 Cortney Ln
Crane, MO 65633
Phone (417) 269-2264

5100 N Towne Centre Dr
Ozark, MO 65721
Phone (417) 269-2215

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

2750 S Campbell Ave
Springfield, MO 65807
Phone (417) 269-2281

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP
  • IA HMO

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1023100773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CORTNEY LN",
            "city": "CRANE",
            "state": "MO",
            "postal_code": "656339192",
            "telephone_number": "417-269-2264",
            "fax_number": "417-269-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "DAMON",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "113023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205040108",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crane, MO

Sources for this page

Verify at the official NPI Registry.