Individual provider Active NPI

Nicole Tayler Thomes, PA-C

  • Medical Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1447097969
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1542 Issued in SD
Practice address
6100 S Louise Ave
Sioux Falls, SD 57108-6029
Phone
(605) 504-1000
Fax
(605) 504-1401
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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 1542 SD Primary

Addresses

Primary practice location

6100 S Louise Ave
Sioux Falls, SD 57108-6029

Mailing address

6100 S Louise Ave
Sioux Falls, SD 57108-6029
Phone (605) 504-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20240909002986 SD Practitioner - Physician Assistant 7810437506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1000 E 23Rd St
Sioux Falls, SD 57105-2114

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

6100 S Louise Ave
Sioux Falls, SD 57108-6029

6300 S Louise Ave
Suite 200
Sioux Falls, SD 57108-6133
Phone (605) 504-1400

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Avera St Lukes Hospital, Aberdeen, SD, CCN 430014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jul 29, 2024 Accepting new patients
Avera McKennan CurrentSince Jul 29, 2024 Accepting new patients
Avera McKennan Past Accepting new patients

Locations

6100 S Louise Ave
Ste 3100
Sioux Falls, SD 57108
Phone (605) 322-8630

6100 S Louise Ave
Sioux Falls, SD 57108
Phone (605) 504-1000

1000 E 23rd St
Ste 100
Sioux Falls, SD 57105
Phone (605) 322-1625

Interoperability endpoints

  • Direct secure messaging: nicole.thomes@avera.sdhealthlink.net

Organizations & group practices 4

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 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1447097969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 S LOUISE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086029",
            "telephone_number": "605-504-1000",
            "fax_number": "605-504-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 S LOUISE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086029",
            "telephone_number": "605-504-1000",
            "fax_number": "605-504-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMES",
        "first_name": "NICOLE",
        "middle_name": "TAYLER",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SD",
            "license": "1542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.