Individual provider Active NPI

Kelly Denise Thomas, MD

  • Psychiatry Physician
  • Fort Stewart, GA
National Provider Identifier
1275894420
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD-17685 Issued in HI
Practice address
1061 Harmon Ave
Winn Army Community Hospital
Fort Stewart, GA 31314-5641
Phone
(912) 435-6965
NPI assigned
Jun 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD-17685 HI
Psychiatry Physician 2084P0800X MD-17685 HI Primary

Addresses

Primary practice location

1061 Harmon Ave
Winn Army Community Hospital
Fort Stewart, GA 31314-5641

Mailing address

1061 Harmon Ave
Winn Army Community Hospital
Fort Stewart, GA 31314-5641
Phone (912) 435-6965

Other names 1

  • Kelly Denise Jones Thomas Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200922003224 VA Practitioner - Psychiatry 3072809011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
West Virginia University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

1802 Braeburn Dr
Salem, VA 24153-7357

2400 Lee Hwy N
Pulaski, VA 24301-2326
Phone (540) 444-4430

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.67 of 100Reported as group
Quality
66.8
Promoting interoperability
100
Improvement activities
40
Cost
75.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-17685HIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Gale Physicians LLC CurrentSince Sep 29, 2021 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1802 Braeburn Dr
Salem, VA 24153
Phone (540) 772-3400

Interoperability endpoints

  • Direct secure messaging: freshfocuspsychiatricservicespllc.kellythomas@146449.advancedmd-direct.com

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.

Hospital & facility affiliations 2

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1275894420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "WINN ARMY COMMUNITY HOSPITAL",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "WINN ARMY COMMUNITY HOSPITAL",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KELLY",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "HI",
            "license": "MD-17685",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-17685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "THOMAS",
            "middle_name": "DENISE JONES",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Stewart, GA

Sources for this page

Verify at the official NPI Registry.