Active NPI
Daisy Marie Thomas, M.D.
- Family Medicine Physician
- Belzoni, MS
National Provider Identifier
1104955301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 07839
- Practice address
- 500 CCC Road
Belzoni, MS 39038 - Phone
- (662) 247-3831
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 07839 | MS | Primary |
Addresses
Primary practice location
500 CCC Road
Belzoni, MS 39038
Mailing address
500 CCC Road
Belzoni, MS 39038
Phone (662) 247-3831
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00018415 | Medicaid | MS |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07839 | MS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1104955301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 CCC ROAD",
"city": "BELZONI",
"state": "MS",
"postal_code": "39038",
"telephone_number": "662-247-3831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CCC ROAD",
"city": "BELZONI",
"state": "MS",
"postal_code": "39038",
"telephone_number": "662-247-3831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "DAISY",
"middle_name": "MARIE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "07839",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00018415",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belzoni, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.