Evan Miller Thomas, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY003899 Issued in GA

Practice address

108 E Ponce de Leon Ave Ste 204
Decatur, GA 30030-2512

Phone

(510) 566-2367

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tamara Weiss, M.D., LLC

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1457898371
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1215056809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25857 FOOTHILLS DR N",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804018556",
            "telephone_number": "510-566-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E PONCE DE LEON AVE STE 204",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302512",
            "telephone_number": "510-566-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2470 Windy Hill Rd SE Ste 362",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678613",
            "country_code": "US",
            "telephone_number": "510-566-2367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2712 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941103104",
            "country_code": "US",
            "telephone_number": "415-401-2757",
            "fax_number": "415-401-2741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "EVAN",
        "middle_name": "MILLER",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "D6540235",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY",
            "identifier": "11415",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "11415",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Schaffer, LLC
• Paul R. Thim, L.M.F.T.
• Rick Davis Thode, PH.D.
• Thomas Eye Group PC
• Cynthia B. Thomas, RN
• Glenn Andrew Thomas
• Inge Hinrichs Thomas, PH.D.
• James Thomas, LMSW
• Janice Thomas, M.A.
• Jessica Lynn Thomas

• Psychologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.