Individual provider Active NPI

Maryann Dawn Thomas, ARNP

  • Family Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1588048086
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95024943 Issued in CA
Practice address
1 Hawthorne St Unit 23D
San Francisco, CA 94105-3984
Phone
(347) 943-8131
NPI assigned
Jul 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-LIC-261868 MT
Family Nurse Practitioner 363LF0000X 5017280 NC
Family Nurse Practitioner 363LF0000X AC006384 MD
Family Nurse Practitioner 363LF0000X AP60578104 WA
Family Nurse Practitioner 363LF0000X 886233 NV
Family Nurse Practitioner 363LF0000X 79969 NM
Family Nurse Practitioner 363LF0000X 322468 AZ
Family Nurse Practitioner 363LF0000X 5371655 ID
Family Nurse Practitioner 363LF0000X 95024943 CA Primary
Family Nurse Practitioner 363LF0000X 234076 AK
Family Nurse Practitioner 363LF0000X C-APN.0103976 CO
Family Nurse Practitioner 363LF0000X APRN-5146 HI
Nurse Practitioner 363L00000X 1098426 TX
Family Nurse Practitioner 363LF0000X 10039355 OR
Family Nurse Practitioner 363LF0000X APRN11024135 FL

Addresses

Primary practice location

1 Hawthorne St Unit 23D
San Francisco, CA 94105-3984

Mailing address

632 Broadway PH 12
New York, NY 10012-2614
Phone (347) 294-3414

Other practice location 1

632 Broadway Ph 12
New York, NY 10012-2614
Phone (347) 294-3414

Other practice location 2

576 Jefferson Ave
Fort Eustis, VA 23604-1373
Phone (757) 314-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150911000721 WA Practitioner - Nurse Practitioner 1759698509 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1098426TXMDNurse Practitioner
234076AKMDFamily Nurse Practitioner
322468AZMDFamily Nurse Practitioner
95024943CAMDFamily Nurse Practitioner
C-APN.0103976COMDFamily Nurse Practitioner
APRN11024135FLMDFamily Nurse Practitioner
APRN-5146HIMDFamily Nurse Practitioner
5371655IDMDFamily Nurse Practitioner
AC006384MDMDFamily Nurse Practitioner
APRN-LIC-261868MTMDFamily Nurse Practitioner
5017280NCMDFamily Nurse Practitioner
79969NMMDFamily Nurse Practitioner
886233NVMDFamily Nurse Practitioner
10039355ORMDFamily Nurse Practitioner
AP60578104WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Community Health Services CurrentSince Aug 1, 2015 Accepting new patients
Lewis County Community Health Services Current Accepting new patients
Lewis County Community Health Services CurrentSince Aug 1, 2015 Accepting new patients

Locations

2690 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 330-9595

617 Cemetery Rd
Winlock, WA 98596
Phone (360) 785-4755

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1588048086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "347-294-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HAWTHORNE ST UNIT 23D",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941053984",
            "telephone_number": "347-943-8131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Broadway Ph 12",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "347-294-3414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "576 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Eustis",
            "state": "VA",
            "postal_code": "236041373",
            "country_code": "US",
            "telephone_number": "757-314-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MARYANN",
        "middle_name": "DAWN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-14",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "APRN-LIC-261868",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5017280",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC006384",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60578104",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "886233",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "79969",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "322468",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "5371655",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95024943",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "234076",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0103976",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-5146",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1098426",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10039355",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024135",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.