NPIMap

Individual provider Active NPI

Alan Craig Thom, D.O.

  • Family Medicine Physician
  • Happy Valley, OR
National Provider Identifier
1134539851
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO177002 Issued in OR
Practice address
9200 SE 91St Ave Ste 220
Happy Valley, OR 97086-3756
Phone
(503) 239-7030
NPI assigned
May 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 DO177002 OR Primary

Addresses

Primary practice location

9200 SE 91St Ave Ste 220
Happy Valley, OR 97086-3756

Mailing address

9200 SE 91St Ave
Ste 220
Happy Valley, OR 97086-3756
Phone (503) 239-7030

Other practice location 1

819 S 13th St
Mount Vernon, WA 98274-4112
Phone (360) 814-6230

Other identifiers 1

IdentifierTypeStateIssuer
500731364MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191216000787 WA Practitioner - Family Practice 5092934893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 299-1350

1213 24TH St
Suite 100
Anacortes, WA 98221-2595
Phone (360) 293-3101

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 2 Skagit County Washington CurrentSince Oct 14, 2019 Accepting new patients
Public Hospital District No 2 Skagit County Washington Current Accepting new patients
Public Hospital District No 2 Skagit County Washington CurrentSince Oct 14, 2019 Accepting new patients
Public Hospital District No 2 Skagit County Washington Past Accepting new patients

Locations

1213 24th St
Ste 100
Anacortes, WA 98221
Phone (360) 293-3101

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134539851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 SE 91ST AVE",
            "address_2": "STE 220",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970863756",
            "telephone_number": "503-239-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 SE 91ST AVE STE 220",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970863756",
            "telephone_number": "503-239-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 S 13th St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744112",
            "country_code": "US",
            "telephone_number": "360-814-6230",
            "fax_number": "360-814-6240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOM",
        "first_name": "ALAN",
        "middle_name": "CRAIG",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO177002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500731364",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Happy Valley, OR

Sources for this page

Verify at the official NPI Registry.