Active NPI
Eric Dwayne Thomas, MD
- Internal Medicine Physician
- Shreveport, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD.203472
- Practice address
- 1501 Kings Hwy
Shreveport, LA 71103-4228 - Phone
- (318) 675-5000
- NPI assigned
- Jun 21, 2008
- Last updated
- Mar 31, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301086709 | MI | |
| Internal Medicine Physician | 207R00000X | MD.203472 | LA | Primary |
Addresses
Primary practice location
1501 Kings Hwy
Shreveport, LA 71103-4228
Mailing address
1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4M586F600 | Other | LA | MEDICARE - PTAN |
| 1809110 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Wayne State University School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2751 Albert L Bicknell Dr
Suite 2D
Shreveport, LA 71103-3939
Phone (318) 212-4232
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD.203472 | LA | MD | Internal Medicine Physician |
| 4301086709 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lsu Health Sciences Center Shreveport Faculty Group Practice | Internal Medicine | Current | Accepting new patients |
| WK Academic Medicine Clinic | Internal Medicine | Current | Accepting new patients |
Locations
1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434
1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287
1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402
2751 Albert L Bicknell Dr
Ste 2D
Shreveport, LA 71103
Phone (318) 212-4232
Interoperability endpoints
- ethomas@direct.wkhs.com
- ethomas3@direct.wkhs.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Shreveport, LA
- NPI 1992375844
-
- Family Medicine Physician
- Shreveport, LA
- NPI 1013374222
Internal Medicine
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba WK Bossier Health Center
- General Acute Care Hospital
- Bossier City, LA
- NPI 1003968579
-
dba Willis Knighton South Hospital
- General Acute Care Hospital
- Shreveport, LA
- NPI 1124170691
-
dba WK Pierremont Health Center
- General Acute Care Hospital
- Shreveport, LA
- NPI 1275685539
-
dba Home Health Departmant Willis Knighton Hospital Inc
- Home Health Agency
- Shreveport, LA
- NPI 1326093782
-
- General Acute Care Hospital
- Shreveport, LA
- NPI 1568461572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427760000000",
"number": "1164683231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 KINGS HWY",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711034228",
"telephone_number": "318-675-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 KINGS HWY",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711034228",
"telephone_number": "318-675-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "ERIC",
"middle_name": "DWAYNE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-21",
"last_updated": "2015-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301086709",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "LA",
"license": "MD.203472",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE - PTAN",
"identifier": "4M586F600",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1809110",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.