Individual provider Active NPI

Thomas John Priest, MD

  • Family Medicine Physician
  • Viera, FL
National Provider Identifier
1477539344
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42869 Issued in FL
Practice address
2900 Veteran'S Way
Viera, FL 32904
Phone
(321) 637-3788
Fax
(321) 637-3619
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME42869 FL
Family Medicine Physician 207Q00000X 42869 FL Primary

Addresses

Primary practice location

2900 Veteran'S Way
Viera, FL 32904

Mailing address

2900 Veteran'S Way
Viera, FL 32904
Phone (321) 637-3788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130801000183 TX Order and Referring Only - Family PracticePractitioner - Family Practice 2466359203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42869FLMDFamily Medicine Physician
ME42869FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Healthcare, Inc. Family Medicine PastSince Dec 1, 1994 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1477539344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 VETERAN'S WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "32904",
            "telephone_number": "321-637-3788",
            "fax_number": "321-637-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 VETERAN'S WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "32904",
            "telephone_number": "321-637-3788",
            "fax_number": "321-637-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIEST",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME42869",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "42869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Viera, FL

Sources for this page

Verify at the official NPI Registry.