Individual provider Active NPI

Jodi Thomas

  • Physician Assistant
  • Bowling Green, KY
National Provider Identifier
1316711377
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3386 Issued in KY
Practice address
5575 Scottsville Rd
Bowling Green, KY 42104-6800
Phone
(270) 282-7088
Fax
(270) 782-6438
NPI assigned
Nov 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X PA3386 KY Primary

Addresses

Primary practice location

5575 Scottsville Rd
Bowling Green, KY 42104-6800

Mailing address

PO Box 90007
Bowling Green, KY 42102-9007
Phone (270) 781-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201002200 KY Practitioner - Physician Assistant 5193173003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

1225 Fairway St
Bowling Green, KY 42103-2477
Phone (270) 781-3910

201 Park St
Bowling Green, KY 42101-1742
Phone (270) 781-5111

2724 Nashville Rd
Bowling Green, KY 42101-4000
Phone 2707815111270

5575 Scottsville Rd
Bowling Green, KY 42104-6800
Phone (270) 781-6477

6807 Louisville Rd
Bowling Green, KY 42101-8015
Phone (270) 781-6477

990 Wilkinson Trce
Bowling Green, KY 42103-3404
Phone (270) 781-4043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA3386KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC Physician Assistant CurrentSince Feb 20, 2025 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Feb 20, 2025 Accepting new patients

Locations

5575 Scottsville Rd
Bowling Green, KY 42104
Phone (270) 282-7088

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

Interoperability endpoints

  • Direct secure messaging: jodithomas@ggc.allscriptsdirect.net

Organizations & group practices 2

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": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1316711377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90007",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421029007",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 SCOTTSVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421046800",
            "telephone_number": "270-282-7088",
            "fax_number": "270-782-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JODI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.