Active NPI
Tamara Sue Thomas, PT
- Physical Therapist
- New Bloomfield, MO
National Provider Identifier
1699005108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 02063
- Practice address
- 3176 Bradley Dr
New Bloomfield, MO 65063-1630 - Phone
- (573) 694-0350
- NPI assigned
- Jan 5, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 02063 | MO | Primary |
Addresses
Primary practice location
3176 Bradley Dr
New Bloomfield, MO 65063-1630
Mailing address
5404 County Road 335
Fulton, MO 65251-5262
Phone (573) 694-0350
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 |
|---|---|---|---|
| 02063 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705017600000",
"number": "1699005108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5404 COUNTY ROAD 335",
"city": "FULTON",
"state": "MO",
"postal_code": "652515262",
"telephone_number": "573-694-0350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3176 BRADLEY DR",
"city": "NEW BLOOMFIELD",
"state": "MO",
"postal_code": "650631630",
"telephone_number": "573-694-0350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "TAMARA",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-05",
"last_updated": "2024-01-12",
"certification_date": "2024-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "02063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bloomfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.