NPIMap

Individual provider Active NPI

Kimberly D. Thomason, P.A.

  • Physician Assistant
  • Webb City, MO
National Provider Identifier
1255870200
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2017004445 Issued in MO
Practice address
6151 N Main Street Rd
Webb City, MO 64870-8189
Phone
(417) 781-0408
NPI assigned
Feb 22, 2017
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1502465 KS
Physician Assistant 363A00000X 2017004445 MO Primary

Addresses

Primary practice location

6151 N Main Street Rd
Webb City, MO 64870-8189

Mailing address

6151 N Main Street Rd
Webb City, MO 64870-8189
Phone (417) 781-0408

Other practice location 1

200 E Centennial Dr Ste 3
Pittsburg, KS 66762-6507
Phone (620) 231-8003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170316001941 MO Practitioner - Physician Assistant 5294010161 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524

1717 S Range Line Rd B
Joplin, MO 64804-3224

6151 N Main St Rd
Webb City, MO 64870-8189
Phone (417) 781-0408

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1502465KSMDPhysician Assistant
2017004445MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman-Oak Hill Health System CurrentSince Apr 27, 2021 Accepting new patients
Gateway Emergency Physicians, LLP CurrentSince Mar 1, 2017 Accepting new patients
Lincoln County Hospital Past Accepting new patients

Locations

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

113 W Hickory St
Neosho, MO 64850
Phone (417) 347-1078

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1255870200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6151 N MAIN STREET RD",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648708189",
            "telephone_number": "417-781-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6151 N MAIN STREET RD",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648708189",
            "telephone_number": "417-781-0408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E Centennial Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Pittsburg",
            "state": "KS",
            "postal_code": "667626507",
            "country_code": "US",
            "telephone_number": "620-231-8003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMASON",
        "first_name": "KIMBERLY",
        "middle_name": "D.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1502465",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2017004445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webb City, MO

Sources for this page

Verify at the official NPI Registry.