Active NPI
Thomas Everts, PA-C
- Physician Assistant
- Colorado Springs, CO
National Provider Identifier
1588092225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.0003817
- Practice address
- 410 Gold Pass HTS
Colorado Springs, CO 80906-3882 - Phone
- (719) 632-5700
- NPI assigned
- Oct 16, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0003817 | CO | Primary |
Addresses
Primary practice location
410 Gold Pass HTS
Colorado Springs, CO 80906-3882
Mailing address
3205 N. Academy Blvd
Suite 130
Colorado Springs, CO 80917
Phone (719) 632-5700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24127779 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Previously, effective Aug 10, 2022 through Aug 10, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- tom.everts@193233818681348.direct.elationemr.com
- tom.everts@214930923257860.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491177600000",
"number": "1588092225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3205 N. ACADEMY BLVD",
"address_2": "SUITE 130",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80917",
"telephone_number": "719-632-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 GOLD PASS HTS",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809063882",
"telephone_number": "719-632-5700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERTS",
"first_name": "THOMAS",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-16",
"last_updated": "2017-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0003817",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "24127779",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.