Individual provider Active NPI

Tina M Thomas, MSW, BSN

  • Clinical Social Worker
  • Metairie, LA
National Provider Identifier
1730453077
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3256 Issued in LA
Practice address
433 Metairie Rd
Metairie, LA 70005-4333
Phone
(985) 789-7897
NPI assigned
Mar 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3256 LA Primary

Addresses

Primary practice location

433 Metairie Rd
Metairie, LA 70005-4333

Mailing address

75368 Moonshadow LN
Abita Springs, LA 70420-4026
Phone (985) 789-7897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150828001342 LA Practitioner - Clinical Social Worker 6800102385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2637 Edenborn Ave
Suite 203
Metairie, LA 70002-7042
Phone (985) 789-7897

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
3256LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Consulting, Inc. Clinical CurrentSince May 3, 2015 Accepting new patients

Locations

2637 Edenborn Ave
Ste 203
Metairie, LA 70002
Phone (985) 789-7897

Organizations & group practices 1

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": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1730453077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75368 MOONSHADOW LN",
            "city": "ABITA SPRINGS",
            "state": "LA",
            "postal_code": "704204026",
            "telephone_number": "985-789-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 METAIRIE RD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700054333",
            "telephone_number": "985-789-7897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "MSW, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "3256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.