Individual provider Active NPI

Sir John Thomas

  • Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1417832528
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209033075 Issued in IL
Practice address
619 E Mason St Ste 4P57
Springfield, IL 62701-1034
Phone
(217) 788-0706
Fax
(217) 525-2535
NPI assigned
Aug 7, 2025
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209033075 IL Primary
Registered Nurse 163W00000X 041417130 IL

Addresses

Primary practice location

619 E Mason St Ste 4P57
Springfield, IL 62701-1034

Mailing address

619 E Mason St Ste 4P57
Springfield, IL 62701-1034
Phone (217) 788-0706

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jthomas495571@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20251008001639 IL Practitioner - Nurse Practitioner 7810494614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 E Mason St
4P57
Springfield, IL 62701-1034
Phone (217) 788-0706

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041417130ILMDRegistered Nurse
209033075ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Cardiovascular Consultants LTD CurrentSince Nov 1, 2025 Accepting new patients

Locations

619 E Mason St
#4P57
Springfield, IL 62701

619 E Mason St
Ste 4P57
Springfield, IL 62701

Interoperability endpoints

  • Direct secure messaging: jthomas495571@ewd.direct.hshs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1754524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1417832528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 E MASON ST STE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E MASON ST STE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SIR JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209033075",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041417130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jthomas495571@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "619 E Mason St Ste 4P57",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627011034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.