Individual provider Active NPI

Carol Thomas, CFNP

  • Family Nurse Practitioner
  • Grants Pass, OR
National Provider Identifier
1093715930
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
099007166 Issued in OR
Practice address
124 NW Midland Ave
Ste J
Grants Pass, OR 97526-1269
Phone
(541) 476-8859
Fax
(541) 955-8611
NPI assigned
Jul 21, 2005
Last updated
May 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 099007166N1 OR
Family Nurse Practitioner 363LF0000X 099007166 OR Primary

Addresses

Primary practice location

124 NW Midland Ave
Ste J
Grants Pass, OR 97526-1269

Mailing address

741 NE 6TH St
Grants Pass, OR 97526-1556
Phone (541) 471-2701

Other identifiers 1

IdentifierTypeStateIssuer
212874MedicaidOR

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
099007166ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Health System Past Accepting new patients
Allcare Medical Group LLC PastSince Jan 1, 2022 Accepting new patients
Mark Allen Rondeau Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: carolthomas@mvfp.allscriptsdirect.net

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1093715930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 NE 6TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261556",
            "telephone_number": "541-471-2701",
            "fax_number": "541-471-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NW MIDLAND AVE",
            "address_2": "STE J",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261269",
            "telephone_number": "541-476-8859",
            "fax_number": "541-955-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "099007166N1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "099007166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212874",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.