Individual provider Active NPI

Staci Jones Thomas, M.D.

  • Pediatrics Physician
  • Morgantown, WV
National Provider Identifier
1104841527
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20750 Issued in WV
Practice address
608 Cheat Rd
Morgantown, WV 26508-4210
Phone
(304) 594-1313
Fax
(304) 594-2408
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20750 WV Primary

Addresses

Primary practice location

608 Cheat Rd
Morgantown, WV 26508-4210

Mailing address

PO Box 1127
Morgantown, WV 26507-1127
Phone (304) 598-4032

Other identifiers 3

IdentifierTypeStateIssuer
1808409000MedicaidWV
404274300MedicaidMD
1012400040001MedicaidPA

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address sthomas607@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address sthomas607@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address sthomas607@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20050607000234 WV Practitioner - Pediatric Medicine 6901849371 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20750WVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Hospitals, Inc. CurrentSince Apr 20, 2011 Accepting new patients
West Virginia University Hospitals Inc Pediatrics Current Accepting new patients
West Virginia University Hospitals, Inc. CurrentSince Apr 20, 2011 Accepting new patients
West Virginia University Medical Corporation CurrentSince Apr 23, 2022 Accepting new patients
West Virginia University Medical Corporation Pediatrics CurrentSince Apr 23, 2022 Accepting new patients

Locations

300 Davisson Run Rd
Clarksburg, WV 26301
Phone (304) 624-2121

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

608 Cheat Rd
Morgantown, WV 26508
Phone (304) 594-1313

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

Interoperability endpoints

  • Direct secure messaging: sthomas607@direct.wvuhsdirect.com

Organizations & group practices 5

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1104841527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1127",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265071127",
            "telephone_number": "304-598-4032",
            "fax_number": "304-598-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 CHEAT RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084210",
            "telephone_number": "304-594-1313",
            "fax_number": "304-594-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "STACI",
        "middle_name": "JONES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "20750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1808409000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404274300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012400040001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sthomas607@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "608 Cheat Rd",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265084210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sthomas607@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "608 Cheat Rd",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265084210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sthomas607@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "608 Cheat Rd",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265084210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.