Jacqueline Claire Thomas

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-164375 Issued in AL

Practice address

19283 Highway 59
Summerdale, AL 36580-3005

Phone

(251) 523-5437

NPI assigned

May 17, 2022

Last updated

Aug 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• USA Health Physician Billing Services LLC

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1720645468
  Medicare reassignment NPD
• Coastal Pediatrics LLC

  • Pediatrics Physician
  • Summerdale, AL
  • NPI 1689438111
  NPD
• USA Health Physician Billing Services LLC

  dba USA Radiology

  • Diagnostic Radiology Physician
  • Mobile, AL
  • NPI 1609434067
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1366189896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19283 HIGHWAY 59",
            "city": "SUMMERDALE",
            "state": "AL",
            "postal_code": "365803005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19283 HIGHWAY 59",
            "city": "SUMMERDALE",
            "state": "AL",
            "postal_code": "365803005",
            "telephone_number": "251-523-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Center St",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366043301",
            "country_code": "US",
            "telephone_number": "251-415-1000",
            "fax_number": "251-415-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JACQUELINE",
        "middle_name": "CLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-164375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Dale Perkins, MD
• Jenny Resmondo, MS, PT
• South Alabama Physiotherapy LLC
• Summerdale Family Medicine, PC
• Shannon Swiderski, MSN, CRNP, FNP-C
• Jerry Wayne Wainwright, LPN
• Kelley Wilson, PH.D.
• Mary Ann Wooten, APRN

• Pediatric Nurse Practitioner in Summerdale, AL
• Providers in Summerdale, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.