Individual provider Active NPI

Thomas Thommi, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1508949611
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME45964 Issued in FL
Practice address
2061 Hyde Park Rd
Jacksonville, FL 32210-3815
Phone
(904) 786-7331
Fax
(904) 786-4034
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME45964 FL Primary

Addresses

Primary practice location

2061 Hyde Park Rd
Jacksonville, FL 32210-3815

Mailing address

PO Box 550698
Jacksonville, FL 32255-0698
Phone (904) 733-6677

Other identifiers 2

IdentifierTypeStateIssuer
ME45964OtherFLFL STATE LICENSE #
043093500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME45964FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1508949611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550698",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322550698",
            "telephone_number": "904-733-6677",
            "fax_number": "904-733-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 HYDE PARK RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322103815",
            "telephone_number": "904-786-7331",
            "fax_number": "904-786-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMMI",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME45964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL STATE LICENSE #",
            "identifier": "ME45964",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043093500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.