Individual provider Active NPI

Kevin Daniel Thomas, DO

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1457937906
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2025037410 Issued in MO
Practice address
1225 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 617-3431
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 2025037410 MO
Family Medicine Physician 207Q00000X 2025037410 MO Primary

Addresses

Primary practice location

1225 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

1225 S Grand Blvd
Saint Louis, MO 63104-1016

Other practice location 1

14021 New Halls Ferry Rd
Florissant, MO 63033-2763
Phone (314) 839-0910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250919003917 MO Practitioner - Family Practice 4183021389 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1225 S Grand Blvd
2L Door 5
Saint Louis, MO 63104-1016
Phone (314) 977-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2025037410MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Sep 1, 2025 Accepting new patients
SSM Medical Group, Inc. CurrentSince Oct 7, 2025 Accepting new patients
SSM Health Care Group Family Medicine CurrentSince Sep 1, 2025 Accepting new patients
SSM Medical Group Inc. CurrentSince Oct 7, 2025 Accepting new patients

Locations

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1225 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-3390

1225 S Grand Blvd
#2L
Saint Louis, MO 63104
Phone (314) 977-4700

Interoperability endpoints

  • Direct secure messaging: kthomas560400@direct-ehr-ssmhc.com

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 2

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1457937906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-617-3431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14021 New Halls Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630332763",
            "country_code": "US",
            "telephone_number": "314-839-0910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KEVIN",
        "middle_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MO",
            "license": "2025037410",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2025037410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.