Individual provider Active NPI

Kayla Marie Thomas, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Putnam, CT
National Provider Identifier
1346972890
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13229 Issued in CT
Practice address
202 Pomfret St
Putnam, CT 06260-1833
Phone
(860) 963-7917
NPI assigned
Jun 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2357613 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2357613 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13229 CT Primary

Addresses

Primary practice location

202 Pomfret St
Putnam, CT 06260-1833

Mailing address

40 Mansfield Ave
Willimantic, CT 06226-2018
Phone (604) 507-4718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240903000086 CT Practitioner - Nurse Practitioner 5193264372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Day Kimball Healthcare, Inc.Group PAC ID 5092773549, 27 clinicians

Practice addresses (Care Compare)

320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 928-6541

Hospital & facility affiliations

  • Day Kimball Hospital Hospital, Putnam, CT, CCN 070003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2357613MAMDRegistered Nurse
RN2357613MAMDPsychiatric/Mental Health Nurse Practitioner

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": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1346972890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "604-507-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601833",
            "telephone_number": "860-963-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "2357613",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2357613",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "13229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.