Individual provider Active NPI

Elbert Austin Thames, M.D.

  • Surgery Physician
  • Snyder, TX
National Provider Identifier
1104829985
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
E4717 Issued in TX
Practice address
1700 Cogdell Blvd
Snyder, TX 79549-6162
Phone
(325) 574-7437
Fax
(325) 574-7433
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X E4717 TX Primary

Addresses

Primary practice location

1700 Cogdell Blvd
Snyder, TX 79549-6162

Mailing address

1700 Cogdell Blvd
Snyder, TX 79549-6162
Phone (325) 574-7437

Other practice location 1

3711 22nd St Ste C
Lubbock, TX 79410-1303
Phone (806) 370-0478

Other identifiers 1

IdentifierTypeStateIssuer
126214907MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050309000883 TX Practitioner - General Surgery 5496720997 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scurry County Hospital District CurrentSince Jun 26, 2017 Accepting new patients
Scurry County Hospital District CurrentSince Jun 26, 2017 Accepting new patients
Covenant Medical Group Surgery Past Accepting new patients
Covenant Medical Group Past Accepting new patients

Locations

3711 22nd St
Ste C
Lubbock, TX 79410
Phone (806) 370-0478

1700 Cogdell Blvd
Snyder, TX 79549
Phone (325) 573-6374

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1104829985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 COGDELL BLVD",
            "city": "SNYDER",
            "state": "TX",
            "postal_code": "795496162",
            "telephone_number": "325-574-7437",
            "fax_number": "325-574-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COGDELL BLVD",
            "city": "SNYDER",
            "state": "TX",
            "postal_code": "795496162",
            "telephone_number": "325-574-7437",
            "fax_number": "325-574-7433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3711 22nd St Ste C",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794101303",
            "country_code": "US",
            "telephone_number": "806-370-0478",
            "fax_number": "325-574-7418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAMES",
        "first_name": "ELBERT",
        "middle_name": "AUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "E4717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126214907",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snyder, TX

Sources for this page

Verify at the official NPI Registry.