Active NPI
Vera Pauline Mansfield, CST, SA-C, CSFA
- Surgical Assistant
- Eagle, ID
National Provider Identifier
1740346188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- Practice address
- 2411 E Riverside Dr Apt H303
Eagle, ID 83616-7552 - Phone
- (208) 724-2223
- NPI assigned
- Dec 29, 2006
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 109984 | ID | |
| Surgical Assistant | 246ZC0007X | 109984 | ID | |
| Surgical Technologist | 246ZS0410X | |||
| Surgical Assistant | 246ZC0007X | Primary |
Addresses
Primary practice location
2411 E Riverside Dr Apt H303
Eagle, ID 83616-7552
Mailing address
2411 E Riverside Dr Apt H303
Eagle, ID 83616-7552
Phone (208) 724-2223
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06-158 | Other | AM BOARD OF SURG ASSIST | |
| 109984 | Other | ID | NBSTSA |
Other names 1
- Vera Pauline Thomas
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 |
|---|---|---|---|
| 109984 | ID | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1740346188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2411 E RIVERSIDE DR APT H303",
"city": "EAGLE",
"state": "ID",
"postal_code": "836167552",
"telephone_number": "208-724-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2411 E RIVERSIDE DR APT H303",
"city": "EAGLE",
"state": "ID",
"postal_code": "836167552",
"telephone_number": "208-724-2223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSFIELD",
"first_name": "VERA",
"middle_name": "PAULINE",
"name_prefix": "Mrs.",
"credential": "CST, SA-C, CSFA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ID",
"license": "109984",
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "ID",
"license": "109984",
"primary": false
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AM BOARD OF SURG ASSIST",
"identifier": "06-158",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NBSTSA",
"identifier": "109984",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "VERA",
"last_name": "THOMAS",
"middle_name": "PAULINE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.