Individual provider Active NPI

Judy Ann Thomas, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1023566551
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
003096 Issued in MO
Practice address
1027 Bellevue Ave Ste LL24
Saint Louis, MO 63117-1851
Phone
(314) 768-8064
Fax
(314) 768-8843
NPI assigned
Sep 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 003096 MO Primary

Addresses

Primary practice location

1027 Bellevue Ave Ste LL24
Saint Louis, MO 63117-1851

Mailing address

1204 Charwood St
Saint Charles, MO 63301-2516
Phone (314) 223-3267

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170109000551 MO Practitioner - Clinical Social Worker 2466733324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vadim Baram MD IncGroup PAC ID 4486725595, 7 clinicians

Practice addresses (Care Compare)

10420 Old Olive St Rd
Suite 205
Saint Louis, MO 63141-5937
Phone (314) 504-4698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003096MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St. Louis CurrentSince Dec 4, 2016 Accepting new patients
Vadim Baram MD, Inc. CurrentSince Apr 3, 2018 Accepting new patients
SSM Health Care St Louis CurrentSince Dec 4, 2016 Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

10420 Old Olive Street Rd
Ste 205
Saint Louis, MO 63141
Phone (314) 603-5986

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1023566551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 CHARWOOD ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012516",
            "telephone_number": "314-223-3267",
            "fax_number": "314-768-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 BELLEVUE AVE STE LL24",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171851",
            "telephone_number": "314-768-8064",
            "fax_number": "314-768-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JUDY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "003096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.