Individual provider Active NPI

Benny Earl Thomas, D.O.

  • Pain Medicine Physician
  • Waynesville, MO
National Provider Identifier
1316960115
Registry record updated Aug 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
34548 Issued in MO
Practice address
215 North St
Waynesville, MO 65583
Phone
(573) 774-6279
Fax
(573) 774-5626
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34548 MO
Pain Medicine Physician 208VP0000X 34548 MO Primary

Addresses

Primary practice location

215 North St
Waynesville, MO 65583

Mailing address

PO Box 4503
215 North St.
Waynesville, MO 65583
Phone (573) 774-6279

Other identifiers 1

IdentifierTypeStateIssuer
240424606MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20060405000017 MO Practitioner - Family Practice 4183632060 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34548MOMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osage Beach Cardiology LTD Past Accepting new patients
Medicom, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786233600000",
    "number": "1316960115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4503",
            "address_2": "215 NORTH ST.",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "65583",
            "telephone_number": "573-774-6279",
            "fax_number": "573-774-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NORTH ST",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "65583",
            "telephone_number": "573-774-6279",
            "fax_number": "573-774-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "BENNY",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2026-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "34548",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MO",
            "license": "34548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240424606",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, MO

Sources for this page

Verify at the official NPI Registry.