Kelly B Thomas, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

46320 Issued in CO

Practice address

1830 Blake Ave
Glenwood Springs, CO 81601-4275

Phone

(970) 945-8503

Fax

(970) 945-0253

NPI assigned

Feb 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Kelly L Brunner Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Arizona College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glenwood Medical Associates PCGroup PAC ID 6901798404, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley View Hospital Association Hospital, Glenwood Springs, CO, CCN 060075

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vvh_him@direct.vvh.org

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.

• Glenwood Medical Assoc

  • Family Medicine Physician
  • Glenwood Springs, CO
  • NPI 1427191501

  Dermatology

  Medicare reassignment Care Compare group NPD
• Glenwood Medical Associates PC

  dba Glenwood Medical Assoc

  • Family Medicine Physician
  • New Castle, CO
  • NPI 1992312813

  Dermatology

  NPD
• Valley View Hospital Association

  • General Acute Care Hospital
  • Glenwood Springs, CO
  • NPI 1982668133
  NPD
• GMJM, LLC

  dba Western Slope Peak Performance

  • Physical Therapist
  • Glenwood Springs, CO
  • NPI 1386716454
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Valley View Hospital Association

  dba Valley View Surgery Center at Basalt

  • Ambulatory Surgical Clinic/Center
  • Basalt, CO
  • NPI 1649885849

  Hospital

  Care Compare affiliation
• Valley View Hospital Association

  • General Acute Care Hospital
  • Glenwood Springs, CO
  • NPI 1982668133
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1659343689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014275",
            "telephone_number": "970-945-8503",
            "fax_number": "970-945-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014275",
            "telephone_number": "970-945-8503",
            "fax_number": "970-945-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KELLY",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "47625",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "35743",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME98103",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "46320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139737",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "992630500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BRUNNER",
            "middle_name": "L",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dermatology Physician in Glenwood Springs, CO
• Providers in Glenwood Springs, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.