Individual provider Active NPI

Diane M Thomas, MD

  • Family Medicine Physician
  • Sparks, NV
National Provider Identifier
1124006044
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9450 Issued in NV
Practice address
4868 Sparks Blvd
Suite 102
Sparks, NV 89436-8207
Phone
(775) 331-5023
Fax
(775) 331-5031
NPI assigned
Jan 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9450 NV Primary

Addresses

Primary practice location

4868 Sparks Blvd
Suite 102
Sparks, NV 89436-8207

Mailing address

4868 Sparks Blvd
Suite 102
Sparks, NV 89436-8207
Phone (775) 331-5023

Other identifiers 3

IdentifierTypeStateIssuer
29D1015353OtherNVCLIA
DQ4188OtherNVRAILROAD MEDICARE
002016817MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address diane.thomas.1@20348.direct.athenahealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20100524000130 NV Practitioner - Family Practice 7315925518 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diane M Thomas M D P C Family Medicine CurrentSince Dec 1, 2002 Accepting new patients

Locations

4868 Sparks Blvd
Ste 102
Sparks, NV 89436
Phone (775) 331-5023

Interoperability endpoints

  • Direct secure messaging: diane.thomas.1@20348.direct.athenahealth.com

Organizations & group practices 1

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1124006044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4868 SPARKS BLVD",
            "address_2": "SUITE 102",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894368207",
            "telephone_number": "775-331-5023",
            "fax_number": "775-331-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4868 SPARKS BLVD",
            "address_2": "SUITE 102",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894368207",
            "telephone_number": "775-331-5023",
            "fax_number": "775-331-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "DIANE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "9450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "29D1015353",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ4188",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002016817",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diane.thomas.1@20348.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "athenanet.athenahealth",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4868 Sparks Blvd",
            "address_2": "Suite 102",
            "city": "Sparks",
            "state": "NV",
            "country_code": "US",
            "postal_code": "894368207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.