Individual provider Active NPI

Erica Michelle Thomas, RN

  • Registered Nurse
  • Troup, TX
National Provider Identifier
1164612735
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
715445 Issued in TX
Practice address
19432 County Road 2138 Ste 200
Troup, TX 75789
Phone
(903) 330-3395
NPI assigned
Jul 30, 2007
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 715445 TX Primary

Addresses

Primary practice location

19432 County Road 2138 Ste 200
Troup, TX 75789

Mailing address

419 S Beckham Ave
Tyler, TX 75702-8309
Phone (903) 597-7700

Other identifiers 2

IdentifierTypeStateIssuer
393611OtherAORN
715445OtherBOARD OF NURSE EXAMINERS

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
715445TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1164612735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028309",
            "telephone_number": "903-597-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19432 COUNTY ROAD 2138 STE 200",
            "city": "TROUP",
            "state": "TX",
            "postal_code": "75789",
            "telephone_number": "903-330-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ERICA",
        "middle_name": "MICHELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "715445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AORN",
            "identifier": "393611",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSE EXAMINERS",
            "identifier": "715445",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troup, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.