Individual provider Active NPI

Sandra Thomas

  • Nurse Practitioner
  • McKee, KY
National Provider Identifier
1083754568
Registry record updated Jan 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2857P Issued in KY
Practice address
US Highway 421
McKee, KY 40447
Phone
(606) 287-8421
Fax
(606) 287-4199
NPI assigned
Feb 7, 2007
Last updated
Jan 9, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2857P KY Primary

Addresses

Primary practice location

US Highway 421
McKee, KY 40447

Mailing address

PO Box 158
Manchester Square Shopping Ctr. Room 212
Manchester, KY 40962-0158
Phone (606) 598-5564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091109000411 KY Practitioner - Nurse Practitioner 7113065301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Richmond St
Mount Vernon, KY 40456-2701
Phone (606) 256-2242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2857PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Valley District Health Department CurrentSince Sep 12, 2009 Accepting new patients
Cumberland Valley District Health Department Current Accepting new patients
Cumberland Valley District Health Department CurrentSince Sep 12, 2009 Accepting new patients

Locations

402 E Clover St
Harlan, KY 40831
Phone (606) 573-3700

330 Shamrock Rd
Manchester, KY 40962
Phone (606) 598-2425

310 S Cherry St
Pineville, KY 40977
Phone (606) 337-7046

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, 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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1083754568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "address_2": "MANCHESTER SQUARE SHOPPING CTR. ROOM 212",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409620158",
            "telephone_number": "606-598-5564",
            "fax_number": "606-598-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HIGHWAY 421",
            "city": "MCKEE",
            "state": "KY",
            "postal_code": "40447",
            "telephone_number": "606-287-8421",
            "fax_number": "606-287-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "2857P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKee, KY

Sources for this page

Verify at the official NPI Registry.