Individual provider Active NPI

Adam Joseph Thomas, PA-C

  • Medical Physician Assistant
  • Dayton, OH
National Provider Identifier
1558668780
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.005899RX Issued in OH
Practice address
1 Elizabeth PL BLDG G
Dayton, OH 45417-3445
Phone
(937) 280-4970
Fax
(937) 630-4578
NPI assigned
Feb 24, 2011
Last updated
May 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-02782 NC
Medical Physician Assistant 363AM0700X 10002678A IN
Medical Physician Assistant 363AM0700X 50.005899RX OH Primary

Addresses

Primary practice location

1 Elizabeth PL BLDG G
Dayton, OH 45417-3445

Mailing address

1 Elizabeth PL BLDG G
Dayton, OH 45417-3445
Phone (937) 280-4970

Other practice location 1

317 Owen Dr
Fayetteville, NC 28304-3429
Phone (910) 568-3903

Other practice location 2

100 N 15th St
Richmond, IN 47374-4355
Phone (765) 966-8221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200207001079 OH Practitioner - Physician Assistant 2264617208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CG Medical Associates IncGroup PAC ID 6608052196, 171 clinicians
Anesthesia and Pain Management LLCGroup PAC ID 2769654193, 5 clinicians

Practice addresses (Care Compare)

101 S Orange St
Xenia, OH 45385-3603
Phone (513) 248-0223

2131 Gateway Dr
Fairborn, OH 45324-6357
Phone (937) 873-9500

2619 Commons Blvd
Suite 130
Beavercreek, OH 45431-3840
Phone (937) 280-4970

3286 Pentagon Blvd
Suite 10
Beavercreek, OH 45431-1789
Phone (937) 490-6511

3604 Wilmington Pike
Kettering, OH 45429-4843
Phone (937) 294-0066

5915 N Main St
Dayton, OH 45415-3104
Phone (937) 278-3826

7300 Beechmont Ave
Cincinnati, OH 45230-4119
Phone (513) 232-9100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10002678AINMDMedical Physician Assistant
50.005899RXOHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Enterprise of Ohio LLC CurrentSince Jul 1, 2020 Accepting new patients
Fayetteville Plastic Surgery Specialists, PA Past Accepting new patients
Anesthesia and Pain Management LLC PastSince Jun 26, 2022 Accepting new patients

Locations

1 Elizabeth Pl
Bldg G
Dayton, OH 45417
Phone (937) 280-4970

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1298505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1558668780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL BLDG G",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "937-280-4970",
            "fax_number": "937-630-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL BLDG G",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "937-280-4970",
            "fax_number": "937-630-4578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043429",
            "country_code": "US",
            "telephone_number": "910-568-3903",
            "fax_number": "910-568-3908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 N 15th St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IN",
            "postal_code": "473744355",
            "country_code": "US",
            "telephone_number": "765-966-8221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ADAM",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-24",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02782",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10002678A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.005899RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.