Frederick W. Thom, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G61780 Issued in CA

Practice address

877 Oak Park Blvd.
Med Plus Medical Center
Pismo Beach, CA 93449

Phone

(805) 474-8450

Fax

(805) 474-8454

NPI assigned

Mar 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Sigmund Physician Service, Inc.

  • Emergency Medicine Physician
  • Paso Robles, CA
  • NPI 1326013657
  NPD (past)
• Sigmund Physician Services, Inc.

  • Emergency Medicine Physician
  • King City, CA
  • NPI 1326112533
  NPD (past)

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1376510529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 CABALLEROS AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017908",
            "telephone_number": "805-549-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 OAK PARK BLVD.",
            "address_2": "MED PLUS MEDICAL CENTER",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "93449",
            "telephone_number": "805-474-8450",
            "fax_number": "805-474-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOM",
        "first_name": "FREDERICK",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G61780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS WORKERS COMP K",
            "identifier": "240629",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DF2146",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPNI",
            "identifier": "5255526",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DOL PROV",
            "identifier": "0217529",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS WORKERS COMP S",
            "identifier": "240630",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G61780",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS WORKERS COMP P",
            "identifier": "235229",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00347364",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Louise Tanous
• Bianca Katalina Crystal Taylor
• The San Luis Obispo Hearing Center, Inc
• The Shoe Tree, Inc
• Sharon M Theodore, M.D.
• Cort Darcy Thompson, PA
• Thrifty Payless Inc
• Total Renal Care Inc
• Kelly Townsend, MSPT
• Traci R. Fernandes, DDS, Inc

• Family Medicine Physician in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.