Organization Active NPI

Clifton E. Thomas, MD, PA

  • Surgery Physician
  • Nacogdoches, TX
National Provider Identifier
1457537540
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
H8861 Issued in TX
Legal business name
CLIFTON E. THOMAS, MD, PA
Practice address
3460 NE Stallings Dr
Nacogdoches, TX 75965-8719
Phone
(936) 569-1889
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Clifton Edwin Thomas, MDNPI 1538144779
Title
Owner/Practitioner
Phone
(936) 569-1889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X H8861 TX Primary

Addresses

Primary practice location

3460 NE Stallings Dr
Nacogdoches, TX 75965-8719

Mailing address

3460 NE Stallings Dr
Nacogdoches, TX 75965-8719
Phone (936) 569-1889

Other identifiers 1

IdentifierTypeStateIssuer
154916401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041005000769 TX Part B Supplier - Clinic/Group Practice 4981663085 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

3460 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 569-1889

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1457537540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759658719",
            "telephone_number": "936-569-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759658719",
            "telephone_number": "936-569-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON E. THOMAS, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "936-569-1889",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "H8861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154916401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.