Active NPI
Shawn Dale Thomas, L.O.
- Orthotist
- Alvarado, TX
National Provider Identifier
1730207754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- 189
- Practice address
- 6812 E Highway 67
Alvarado, TX 76009-6857 - Phone
- (817) 783-2757
- Fax
- (866) 591-2741
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthotist | 222Z00000X | 189 | TX | Primary |
Addresses
Primary practice location
6812 E Highway 67
Alvarado, TX 76009-6857
Mailing address
6812 E Highway 67
Alvarado, TX 76009-6857
Phone (817) 783-2757
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 189 | Other | TX | ORTHOTIC LICENSE |
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 |
|---|---|---|---|
| 189 | TX | MD | Orthotist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324339200000",
"number": "1730207754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6812 E HIGHWAY 67",
"city": "ALVARADO",
"state": "TX",
"postal_code": "760096857",
"telephone_number": "817-783-2757",
"fax_number": "866-591-2741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6812 E HIGHWAY 67",
"city": "ALVARADO",
"state": "TX",
"postal_code": "760096857",
"telephone_number": "817-783-2757",
"fax_number": "866-591-2741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "SHAWN",
"middle_name": "DALE",
"name_prefix": "Mr.",
"credential": "L.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2011-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "TX",
"license": "189",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ORTHOTIC LICENSE",
"identifier": "189",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alvarado, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.