NPIMap

Individual provider Active NPI

Thomas C Conder, D.O.

  • Surgery Physician
  • Bowie, TX
National Provider Identifier
1699778332
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M5671 Issued in TX
Practice address
1010 N Mill St
Bowie, TX 76230-3120
Phone
(940) 872-1121
Fax
(940) 872-3007
NPI assigned
May 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2000174336 MO
Emergency Medicine Physician 207P00000X M5671 TX
Surgery Physician 208600000X M5671 TX Primary

Addresses

Primary practice location

1010 N Mill St
Bowie, TX 76230-3120

Mailing address

1010 N Mill St
Bowie, TX 76230-3120
Phone (940) 872-1121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041111000867 MO Practitioner - Emergency MedicinePractitioner - General Surgery 6406819283 Reassigns benefits to 1 organization
I20070719000614 TX Practitioner - Emergency MedicinePractitioner - General SurgeryPractitioner - Family Practice 6406819283 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2000174336MOMDSurgery Physician
M5671TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC Emergency Medicine Current Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Dec 20, 2010 Accepting new patients
Bothwell Regional Health Center CurrentSince Jul 16, 2022 Accepting new patients
Bothwell Regional Health Center CurrentSince Jul 16, 2022 Accepting new patients
Panola Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine Past Accepting new patients
Camp Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Sabine County Hospital District Emergency Medicine Past Accepting new patients

Locations

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

1021 Holden St
Glen Rose, TX 76043
Phone (254) 897-1425

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

821 Jeffee Dr
Kermit, TX 79745
Phone (432) 586-2040

920 Hillcrest Dr
Vernon, TX 76384
Phone (940) 552-9351

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1116979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1699778332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N MILL ST",
            "city": "BOWIE",
            "state": "TX",
            "postal_code": "762303120",
            "telephone_number": "940-872-1121",
            "fax_number": "940-872-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N MILL ST",
            "city": "BOWIE",
            "state": "TX",
            "postal_code": "762303120",
            "telephone_number": "940-872-1121",
            "fax_number": "940-872-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDER",
        "first_name": "THOMAS",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-25",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2000174336",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M5671",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "M5671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, TX

Sources for this page

Verify at the official NPI Registry.