Active NPI
Jamie Thomas, OD
- Optometrist
- Pocatello, ID
National Provider Identifier
1124014295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ODP100029
- Practice address
- 1155 Pocatello Creek Rd
Pocatello, ID 83201-2949 - Phone
- (208) 233-2020
- Fax
- (208) 233-2021
- NPI assigned
- Sep 23, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODP100029 | ID | Primary |
Addresses
Primary practice location
1155 Pocatello Creek Rd
Pocatello, ID 83201-2949
Mailing address
1155 Pocatello Creek Rd
Pocatello, ID 83201-2949
Phone (208) 233-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002446900 | Medicaid | ID |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODP100029 | ID | MD | Optometrist |
Interoperability endpoints
- https://api.platform.athenahealth.com/27506/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302652800000",
"number": "1124014295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 POCATELLO CREEK RD",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832012949",
"telephone_number": "208-233-2020",
"fax_number": "208-233-2021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 POCATELLO CREEK RD",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832012949",
"telephone_number": "208-233-2020",
"fax_number": "208-233-2021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "JAMIE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-23",
"last_updated": "2011-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "ODP100029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002446900",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
- The Health & Wellness Sleep Institute of Pocatello,LLC
- The Health and Wellness Sleep Institute of Pocatello LLC
- The Lymphatic Care Institute
- Angelina Thelin, L.M.T.
- Therapy Links Inc
- John H Thomas, MD
- Jordan Dennis Thomas, LPC
- Kimberly Jean Thomas, FNP-C
- Taylor James Thomason
- Elizabeth Thompson Jefferis
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.