NPIMap

Individual provider Active NPI

Thomas John Boone, M.D.

  • Family Medicine Physician
  • Chewelah, WA
National Provider Identifier
1346325750
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00016174 Issued in WA
Practice address
410 E King Street
Chewelah, WA 99109-0137
Phone
(509) 935-8711
Fax
(509) 935-4882
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00016174 WA Primary

Addresses

Primary practice location

410 E King Street
Chewelah, WA 99109-0137

Mailing address

PO Box 137
Chewelah, WA 99109-0137
Phone (509) 935-8711

Other identifiers 2

IdentifierTypeStateIssuer
16668OtherWAWA STATE L&I
1356005MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20071107000684 WA Practitioner - Family Practice 1355438318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Harvard Medical School, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chewelah Associated Physicians PSGroup PAC ID 9537057765, 4 clinicians

Practice addresses (Care Compare)

410 E King Ave
Chewelah, WA 99109-7012
Phone (509) 935-8711

PO Box
Suite 137
Chewelah, WA 99109-0137

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chewelah Associated Physicians PS Family Medicine CurrentSince Sep 23, 1977 Accepting new patients
Chewelah Associated Physicians Family Medicine Past Accepting new patients
Chewelah Associated Physicians Family Medicine Past Accepting new patients

Locations

410 E King Ave
Chewelah, WA 99109
Phone (509) 935-8711

500 E Webster Ave
Chewelah, WA 99109
Phone (509) 482-2154

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Chewelah Associated PhysiciansChewelah, WA, CCN 503868 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 2, 1979

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 4

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1346325750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 137",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991090137",
            "telephone_number": "509-935-8711",
            "fax_number": "509-935-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E KING STREET",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991090137",
            "telephone_number": "509-935-8711",
            "fax_number": "509-935-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00016174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE L&I",
            "identifier": "16668",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356005",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chewelah, WA

Sources for this page

Verify at the official NPI Registry.