Individual provider Active NPI

Stephanie Thomas, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1184761702
Registry record updated Dec 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P2795 Issued in TX
Practice address
6301 Gaston Ave
Suite 190P
Dallas, TX 75214-3922
Phone
(469) 619-6550
Fax
(469) 334-0507
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P2795 TX Primary

Addresses

Primary practice location

6301 Gaston Ave
Suite 190P
Dallas, TX 75214-3922

Mailing address

6301 Gaston Ave
Suite 190P
Dallas, TX 75214-3922
Phone (469) 619-6550

Other identifiers 1

IdentifierTypeStateIssuer
02713486MedicaidNY

Other names 1

  • Stephanie David Former name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P2795TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care of the Treasure Coast, Inc. Past Accepting new patients
Primary Care of the Treasure Coast, Inc. Internal Medicine Past Accepting new patients
Greater Dallas Healthcare Enterprises Past Accepting new patients
Hillside Polymedic P.C. Internal Medicine Past Accepting new patients
Hillside Polymedic Diagnostic & Treatment Center Inc PastSince Apr 8, 2009 Accepting new patients
Greater Dallas Healthcare Enterprises Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephanie.thomas.p63@direct.tenet.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387843200000",
    "number": "1184761702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 GASTON AVE",
            "address_2": "SUITE 190P",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752143922",
            "telephone_number": "469-619-6550",
            "fax_number": "469-334-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 GASTON AVE",
            "address_2": "SUITE 190P",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752143922",
            "telephone_number": "469-619-6550",
            "fax_number": "469-334-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "STEPHANIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2013-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P2795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02713486",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "DAVID",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2013; 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.