Active NPI
Jason Thomas, RNFA
- Medical-Surgical Registered Nurse
- Jefferson City, MO
National Provider Identifier
1649431420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- 2004003193
- Practice address
- 1616 Southridge Dr
Ste 202
Jefferson City, MO 65109-5677 - Phone
- (573) 635-0401
- Fax
- (573) 635-6715
- NPI assigned
- Jun 24, 2008
- 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 |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 2004003193 | MO | Primary |
Addresses
Primary practice location
1616 Southridge Dr
Ste 202
Jefferson City, MO 65109-5677
Mailing address
1616 Southridge Dr
Ste 202
Jefferson City, MO 65109-5677
Phone (573) 635-0401
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 062603 | Other | MO | CNOR CERTIFICATE FOR PROFESSIONAL ACHIEVEMENT IN PERIOPERATIVE NURSING PRACTICE |
| CEP11471 | Other | MO | NIFA RN FIRST ASSISTANT PROGRAM COMPLETION CERTIFICATE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004003193 | MO | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291852800000",
"number": "1649431420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 SOUTHRIDGE DR",
"address_2": "STE 202",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651095677",
"telephone_number": "573-635-0401",
"fax_number": "573-635-6715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 SOUTHRIDGE DR",
"address_2": "STE 202",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651095677",
"telephone_number": "573-635-0401",
"fax_number": "573-635-6715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "JASON",
"credential": "RNFA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-24",
"last_updated": "2010-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "MO",
"license": "2004003193",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CNOR CERTIFICATE FOR PROFESSIONAL ACHIEVEMENT IN PERIOPERATIVE NURSING PRACTICE",
"identifier": "062603",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NIFA RN FIRST ASSISTANT PROGRAM COMPLETION CERTIFICATE",
"identifier": "CEP11471",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.