Amanda B Thomas

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2365 Issued in MS

Practice address

6250 Old Canton Rd Ste 130
Jackson, MS 39211-2946

Phone

(601) 956-7280

Fax

(601) 977-6244

NPI assigned

Aug 3, 2012

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amanda Catherine Bacon Former name

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": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053667444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "telephone_number": "901-227-3255",
            "fax_number": "901-227-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 OLD CANTON RD STE 130",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112946",
            "telephone_number": "601-956-7280",
            "fax_number": "601-977-6244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 Lakeland Dr",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392328947",
            "country_code": "US",
            "telephone_number": "601-939-7010",
            "fax_number": "601-939-3332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 N State St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392022000",
            "country_code": "US",
            "telephone_number": "601-714-3202",
            "fax_number": "601-714-3416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7273 S Siwell Rd",
            "address_purpose": "LOCATION",
            "city": "Byram",
            "state": "MS",
            "postal_code": "392729776",
            "country_code": "US",
            "telephone_number": "601-372-8223",
            "fax_number": "601-372-8125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 Clinton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MS",
            "postal_code": "390564730",
            "country_code": "US",
            "telephone_number": "601-926-2018",
            "fax_number": "601-924-9746",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Baptist Dr Ste 306",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391102012",
            "country_code": "US",
            "telephone_number": "601-607-7204",
            "fax_number": "601-607-7430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "746 E Fifteenth St",
            "address_purpose": "LOCATION",
            "city": "Yazoo City",
            "state": "MS",
            "postal_code": "391942706",
            "country_code": "US",
            "telephone_number": "662-746-4032",
            "fax_number": "662-746-0967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "AMANDA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT2365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02986263",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BACON",
            "middle_name": "CATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Josny Thimothee
• Aditi N Thiru, MD
• Kyle Thistle, MD
• Thomas P. Mills, M.D., PLLC (Digestive Healthcare Clinic)
• Aby Thomas, M.D.
• Annette Thomas
• Cassandra Faye Thomas, M.D.
• Charles Sumner Thomas, MD
• Christopher Thomas
• Devorah Thomas

• Physical Therapist in Jackson, MS
• Providers in Jackson, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.