Individual provider Active NPI

Virginia Lee Thomas, M.D.

  • Pediatrics Physician
  • Fayetteville, AR
National Provider Identifier
1033326434
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-6116 Issued in AR
Practice address
3380 N Futrall Dr Ste 1
Fayetteville, AR 72703
Phone
(479) 442-7322
Fax
(479) 442-7379
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-6116 AR Primary

Addresses

Primary practice location

3380 N Futrall Dr Ste 1
Fayetteville, AR 72703

Mailing address

PO Box 1523
Fayetteville, AR 72702-1523
Phone (479) 571-6038

Other practice location 1

3383 N Mana Ct Ste 101
Fayetteville, AR 72703-4965
Phone (479) 443-3471

Other identifiers 2

IdentifierTypeStateIssuer
181555001MedicaidAR
5H710OtherARAR BC/BS

Other names 1

  • Virginia Lee McCord Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address virginia.thomas@mana.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100811000095 AR Practitioner - Pediatric Medicine 7810021094 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-6116ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Northwest Arkansas, PA CurrentSince Jul 1, 2013 Accepting new patients
Medical Associates of Northwest Arkansas, PA Current Accepting new patients
Medical Associates of Northwest Arkansas PA CurrentSince Jul 1, 2013 Accepting new patients
Medical Associates of Northwest Arkansas PA Pediatrics Past Accepting new patients
Medical Associates of Northwest Arkansas PA Past Accepting new patients
Medical Associates of Northwest Arkansas PA Pediatrics Past Accepting new patients
Medical Associates of Northwest Arkansas PA Past Accepting new patients

Locations

3380 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 442-7322

3383 N Mana Ct
Ste 101
Fayetteville, AR 72703
Phone (479) 442-7322

3344 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 582-7213

3380 N Futrall Dr
Ste 3
Fayetteville, AR 72703
Phone (479) 442-7322

3380 N Futrall Dr
Ste 1
Fayetteville, AR 72703
Phone (479) 442-7322

3730 S Pinnacle Hills Pkwy
Ste 3
Rogers, AR 72758
Phone (479) 221-8902

Interoperability endpoints

  • Direct secure messaging: virginia.thomas@mana.eclinicaldirectplus.com

Organizations & group practices 7

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1033326434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021523",
            "telephone_number": "479-571-6038",
            "fax_number": "479-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 N FUTRALL DR STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-442-7322",
            "fax_number": "479-442-7379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3383 N Mana Ct Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727034965",
            "country_code": "US",
            "telephone_number": "479-443-3471",
            "fax_number": "479-442-7379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "VIRGINIA",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-6116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181555001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BC/BS",
            "identifier": "5H710",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "virginia.thomas@mana.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "virginia.thomas@mana.eclinicaldirectplus.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3380 N Futrall Dr Ste 1",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "72703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "MCCORD",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.