NPIMap

Organization Active NPI

Sean R Thomas MD, Inc

  • Family Medicine Physician
  • Twentynine Palms, CA
National Provider Identifier
1497970255
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A60305 Issued in CA
Legal business name
SEAN R THOMAS MD, INC
Practice address
6186 Adobe Rd
Twentynine Palms, CA 92277-2652
Phone
(760) 361-8525
Fax
(760) 361-8528
NPI assigned
Apr 16, 2007
Organization subpart
Yes
Parent organization
SEAN R THOMAS MD, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Authorized official

Name
Januarie Bautista
Title
Contracts Director
Phone
(760) 228-3366

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X A60305 CA Primary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X A60305 CA

Addresses

Primary practice location

6186 Adobe Rd
Twentynine Palms, CA 92277-2652

Mailing address

55585 29 Palms Hwy
Yucca Valley, CA 92284-2505
Phone (760) 228-3366

Other identifiers 2

IdentifierTypeStateIssuer
GR0089550MedicaidCA
GR0089550OtherCAGROUP / RH#

Other names 1

  • American Desert Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sean R Thomas MD Inc4 organizations share this tax ID, including this one
Part of
Sean R Thomas MD Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1497970255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55585 29 PALMS HWY",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842505",
            "telephone_number": "760-228-3366",
            "fax_number": "760-228-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6186 ADOBE RD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922772652",
            "telephone_number": "760-361-8525",
            "fax_number": "760-361-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN R THOMAS MD, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEAN R THOMAS MD, INC",
        "enumeration_date": "2007-04-16",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "JANUARIE",
        "authorized_official_title_or_position": "CONTRACTS DIRECTOR",
        "authorized_official_telephone_number": "760-228-3366"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A60305",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A60305",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089550",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP / RH#",
            "identifier": "GR0089550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Desert Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Twentynine Palms, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.