Individual provider Active NPI

Holly Marie Thomas, CRNA

  • Certified Registered Nurse Anesthetist
  • Meridian, MS
National Provider Identifier
1033646120
Registry record updated May 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
892715 Issued in MS
Practice address
2124 14TH St
Meridian, MS 39301-4040
Phone
(601) 353-6341
Fax
(844) 752-2164
NPI assigned
May 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 892715 MS Primary

Addresses

Primary practice location

2124 14TH St
Meridian, MS 39301-4040

Mailing address

3340 Players Club Pkwy Ste 350
Memphis, TN 38125-8949
Phone (901) 207-2017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170721002951 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698045771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians

Practice addresses (Care Compare)

1100 Belk Blvd
Oxford, MS 38655-5242
Phone (662) 232-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
901441MSMDNurse Practitioner
892715MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 27, 2017 Accepting new patients

Locations

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495152000000",
    "number": "1033646120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PLAYERS CLUB PKWY STE 350",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258949",
            "telephone_number": "901-207-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014040",
            "telephone_number": "601-353-6341",
            "fax_number": "844-752-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-19",
        "last_updated": "2017-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "892715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.