Thomas Thomas, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21092 Issued in WI

Practice address

117 E Green Bay St
Shawano, WI 54166-2443

Phone

(715) 524-2161

Fax

(715) 524-5658

NPI assigned

Jun 27, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Radiology Associates of Appleton, S.C.

  • Diagnostic Radiology Physician
  • Appleton, WI
  • NPI 1841229093
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1457388233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-996-3298",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E GREEN BAY ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662443",
            "telephone_number": "715-524-2161",
            "fax_number": "715-524-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "21092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30106900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thedacare, Incorporated
• Thedacare, Incorporated
• Paul Michael Theuerkauf, P.T.
• Nicholas Thiel, PTA
• Shantel Thomas
• Bentley Jessica Mae Thomason, MD
• Heidi Lee Thompson, P.T.A.
• Ann Renae Thornock, APNP - FAMILY
• Ty D Thornock, CRNA
• Mark Robert Tolsma, COTA

• Family Medicine Physician in Shawano, WI
• Providers in Shawano, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.