NPIMap

Individual provider Active NPI

Ian Thomas Head, PARAMEDIC

  • Physician Assistant
  • West Lebanon, NH
National Provider Identifier
1093577017
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
055.0031845 Issued in VT
Practice address
24 Airport Rd
West Lebanon, NH 03784-1663
Phone
(603) 298-5594
NPI assigned
Jan 25, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 055.0031845 VT Primary
Physician Assistant 363A00000X PA2024-0042 NM

Addresses

Primary practice location

24 Airport Rd
West Lebanon, NH 03784-1663

Mailing address

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Other practice location 1

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240827003423 NM Practitioner - Physician Assistant 3870032469 Reassigns benefits to 1 organization
I20251209001709 VT Practitioner - Physician Assistant 3870032469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Hospital & facility affiliations

  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
055.0031845VTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group, Inc. CurrentSince Jun 14, 2024 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Nov 28, 2025 Accepting new patients

Locations

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

Organizations & group practices 15

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.

View all 15

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": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1093577017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 AIRPORT RD",
            "city": "WEST LEBANON",
            "state": "NH",
            "postal_code": "037841663",
            "telephone_number": "603-298-5594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEAD",
        "first_name": "IAN",
        "middle_name": "THOMAS",
        "credential": "PARAMEDIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-25",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031845",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2024-0042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lebanon, NH

Sources for this page

Verify at the official NPI Registry.