Sierra Ray Thomas, PA-C
Individual provider Active NPI Physician Assistant · Kingsport, TN
NPI 1124620190 · NPPES record last updated Aug 3, 2022
Key facts
- NPI
- 1124620190
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 3 Sheridan SQ
Kingsport, TN 37660-7390 - Phone
- (423) 392-6840
- Fax
- (423) 392-6845
- NPI assigned
- Nov 13, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210227000169 | TN | Practitioner - Physician Assistant | 6507271483 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Pain Specialists, PC | Current |
Accepting new patients |
Locations
2103 Forest Dr
Ste 5
Gray, TN 37615
Phone (423) 477-2885
1326 Papermill Pointe Way
Knoxville, TN 37909
Phone (865) 219-3506
1342 Papermill Pointe Way
Knoxville, TN 37909
Phone (865) 219-3506
Interoperability endpoints
- sierra.thomas.p1@direct.aak.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
3 Sheridan SQ
Kingsport, TN 37660-7390
Mailing address
3 Sheridan SQ
Kingsport, TN 37660-7390
Phone (423) 392-6840
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124620190 | Other | NPI | |
| Q064038 | Medicaid | TN |
Other providers in Kingsport, TN
- Julia Thie
- Thomas Sturdavant MD PA
- Chadwick J Thomas
- Erin Elizabeth Thomas
- Miranda Deshawna Thomas
- Thomas Thomas
- Thompson Delivery Services LLC
- Gabriel Ian Guthrie Thompson
- Grant Cole Thompson
- Kelly Lauren Thompson
All providers in Kingsport, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.