Active NPI
Carolyn Marie Thomas, R.D.,L.D.
- Registered Dietitian
- Louisville, KY
National Provider Identifier
1104004043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 124752
- Practice address
- 950 Breckenridge LN Ste 10
Louisville, KY 40207-5931 - Phone
- (502) 894-9499
- Fax
- (502) 894-9595
- NPI assigned
- Feb 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2075 | KY | |
| Registered Dietitian | 133V00000X | 1685 | TN | |
| Registered Dietitian | 133V00000X | 124752 | KY | Primary |
Addresses
Primary practice location
950 Breckenridge LN Ste 10
Louisville, KY 40207-5931
Mailing address
3008 W Highway 42
La Grange, KY 40031-7527
Phone (615) 306-0294
Other names 1
- Carolyn Boice
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124752 | KY | MD | Registered Dietitian |
| 2075 | KY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Health Medical Group Inc | Current | Accepting new patients | |
| Baptist Medical Associates Inc | Current | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Locations
950 Breckenridge Ln
Ste 10
Louisville, KY 40207
Phone (502) 894-9499
3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313
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 and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Dawson Springs, KY
- NPI 1982178216
-
- Neurology Physician
- Louisville, KY
- NPI 1386872471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1104004043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3008 W HIGHWAY 42",
"city": "LA GRANGE",
"state": "KY",
"postal_code": "400317527",
"telephone_number": "615-306-0294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 BRECKENRIDGE LN STE 10",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402075931",
"telephone_number": "502-894-9499",
"fax_number": "502-894-9595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "CAROLYN",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "R.D.,L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-01",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "2075",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "1685",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "124752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLYN",
"last_name": "BOICE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.