Individual provider Active NPI

Gary Thomas, PH.D.

  • Clinical Psychologist
  • Mesa, AZ
National Provider Identifier
1083772750
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
883 Issued in AZ
Practice address
1424 S. Stapley Dr.
Mesa, AZ 85204-5877
Phone
(480) 982-2356
NPI assigned
Dec 5, 2006
Last updated
Dec 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1043460397 AZ
Clinical Psychologist 103TC0700X 883 AZ Primary

Addresses

Primary practice location

1424 S. Stapley Dr.
Mesa, AZ 85204-5877

Mailing address

6240 E Snowdon St
Mesa, AZ 85215-9632
Phone (602) 501-9858

Other identifiers 1

IdentifierTypeStateIssuer
727943MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1043460397AZMDPsychologist
883AZMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
San Tan Counseling LLC Single Specialty Past Accepting new patients
Magellan Health Services of Arizona, Inc Past Accepting new patients
Superstition Springs Counseling Services of Arizona Single Specialty Past Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients

Organizations & group practices 4

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1083772750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 E SNOWDON ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852159632",
            "telephone_number": "602-501-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 S. STAPLEY DR.",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045877",
            "telephone_number": "480-982-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "GARY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "1043460397",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "727943",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.