Active NPI
Priya Daisy Thomas, PA
- Physician Assistant
- Woodward, IA
National Provider Identifier
1578755328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001923
- Practice address
- 1251 , 334TH Street
Woodward Resource Center
Woodward, IA 50276 - Phone
- (515) 438-3265
- Fax
- (515) 438-3631
- NPI assigned
- Aug 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 010623-1 | NY | |
| Physician Assistant | 363A00000X | 001923 | Primary |
Addresses
Primary practice location
1251 , 334TH Street
Woodward Resource Center
Woodward, IA 50276
Mailing address
15426 Wildwood Drive
Clive, IA 50325
Phone (515) 438-3265
Other names 1
- Mrs. Priya Daisy Philip
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220415000318 | IA | Order and Referring Only - Physician Assistant | 5092889683 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010623-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576627200000",
"number": "1578755328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15426 WILDWOOD DRIVE",
"city": "CLIVE",
"state": "IA",
"postal_code": "50325",
"telephone_number": "515-438-3265",
"fax_number": "515-438-3631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1251 , 334TH STREET",
"address_2": "WOODWARD RESOURCE CENTER",
"city": "WOODWARD",
"state": "IA",
"postal_code": "50276",
"telephone_number": "515-438-3265",
"fax_number": "515-438-3631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "PRIYA",
"middle_name": "DAISY",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-15",
"last_updated": "2019-12-18",
"certification_date": "2019-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "010623-1",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "001923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PRIYA",
"last_name": "PHILIP",
"middle_name": "DAISY",
"prefix": "MRS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Woodward, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.