Individual provider Active NPI

Steven S Thomas, M.D.

  • Dermatology Physician
  • Tucker, GA
National Provider Identifier
1235157348
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
21834 Issued in GA
Practice address
2185 Northlake Pkwy
Suite 104
Tucker, GA 30084-4126
Phone
(770) 934-7200
Fax
(770) 934-7243
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 21834 GA Primary

Addresses

Primary practice location

2185 Northlake Pkwy
Suite 104
Tucker, GA 30084-4126

Mailing address

2185 Northlake Pkwy
Suite 104
Tucker, GA 30084-4126
Phone (770) 934-7200

Other identifiers 2

IdentifierTypeStateIssuer
029499OtherBLUE CROSS/BS
00282884CMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151229000984 NC Order and Referring Only - DermatologyPractitioner - Dermatology 9032201082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21834GAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steven S. Thomas, MD, P.C. Dermatology PastSince Apr 23, 2011 Accepting new patients

Organizations & group practices 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235157348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 NORTHLAKE PKWY",
            "address_2": "SUITE 104",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844126",
            "telephone_number": "770-934-7200",
            "fax_number": "770-934-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 NORTHLAKE PKWY",
            "address_2": "SUITE 104",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844126",
            "telephone_number": "770-934-7200",
            "fax_number": "770-934-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "STEVEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "21834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BS",
            "identifier": "029499",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00282884C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.