Individual provider Active NPI

Christopher Matthew Thomas, CRNA

  • Certified Registered Nurse Anesthetist
  • Bowling Green, KY
National Provider Identifier
1699040386
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1114198 Issued in KY
Practice address
350 Park St
Suite 203B
Bowling Green, KY 42101-1784
Phone
(270) 393-1912
Fax
(270) 393-1913
NPI assigned
Mar 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1114198 KY Primary

Addresses

Primary practice location

350 Park St
Suite 203B
Bowling Green, KY 42101-1784

Mailing address

350 Park St
Suite 203B
Bowling Green, KY 42101-1784
Phone (270) 393-1912

Other identifiers 1

IdentifierTypeStateIssuer
7100210340MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120712000673 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567627771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Park St
Bowling Green, KY 42101-1760
Phone (270) 745-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1114198KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients

Locations

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1699040386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PARK ST",
            "address_2": "SUITE 203B",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011784",
            "telephone_number": "270-393-1912",
            "fax_number": "270-393-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PARK ST",
            "address_2": "SUITE 203B",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011784",
            "telephone_number": "270-393-1912",
            "fax_number": "270-393-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CHRISTOPHER",
        "middle_name": "MATTHEW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-14",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1114198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100210340",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.