Individual provider Active NPI

Janalea Kristin Thomas, PA-C

  • Medical Physician Assistant
  • Bonita Springs, FL
National Provider Identifier
1396977419
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA3342 Issued in FL
Practice address
9776 Bonita Beach Rd SE
Suite 102
Bonita Springs, FL 34135-4773
Phone
(239) 949-1777
Fax
(239) 498-3777
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3342 FL Primary

Addresses

Primary practice location

9776 Bonita Beach Rd SE
Suite 102
Bonita Springs, FL 34135-4773

Mailing address

PO Box 166321
Miami, FL 33116-6321
Phone (239) 949-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA3342FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Coastal Surgery Center, Inc Past Accepting new patients
David C Ritter M D Surgical Oncology and General Surgery P a PastSince Jun 20, 2008 Accepting new patients

Organizations & group practices 2

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": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1396977419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 166321",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331166321",
            "telephone_number": "239-949-1777",
            "fax_number": "239-498-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9776 BONITA BEACH RD SE",
            "address_2": "SUITE 102",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354773",
            "telephone_number": "239-949-1777",
            "fax_number": "239-498-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JANALEA",
        "middle_name": "KRISTIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA3342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.