Individual provider Active NPI

Jessica Anne Thomas, MD

  • Hematology & Oncology Physician
  • Royal Oak, MI
National Provider Identifier
1235715715
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4351053568 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(248) 898-5000
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X 4351053568 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

25090 Woodward Ave Apt 244
Royal Oak, MI 48067-0988
Phone (689) 266-9298

Other practice location 1

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-7573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210802000822 GA Order and Referring Only - Internal MedicinePractitioner - Hematology/OncologyPractitioner - Internal Medicine 1557765377

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351053568MIMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1235715715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25090 WOODWARD AVE APT 244",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480670988",
            "telephone_number": "689-266-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-7573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4351053568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.