Active NPI
Bradley Jonathan Thomas, M.D.
- Anesthesiology Physician
- Truckee, CA
National Provider Identifier
1679523617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G58233
- Practice address
- 10121 Pine Ave
Truckee, CA 96161-4835 - Phone
- (530) 587-6011
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G58233 | CA | Primary |
Addresses
Primary practice location
10121 Pine Ave
Truckee, CA 96161-4835
Mailing address
PO Box 34120
Reno, NV 89533-4120
Phone (775) 747-5050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G582331 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7725 | NV | MD | General Practice Dentistry |
| G58233 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253059200000",
"number": "1679523617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34120",
"city": "RENO",
"state": "NV",
"postal_code": "895334120",
"telephone_number": "775-747-5050",
"fax_number": "775-747-5005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10121 PINE AVE",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961614835",
"telephone_number": "530-587-6011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "BRADLEY",
"middle_name": "JONATHAN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2009-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G58233",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G582331",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Truckee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.