Individual provider Active NPI

Thomas Joseph Patterson, D.M.D.

  • General Practice Dentistry
  • Twin Falls, ID
National Provider Identifier
1770037038
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-5112 Issued in ID
Practice address
236 River Vista PL Ste 100
Twin Falls, ID 83301-4078
Phone
(208) 737-5253
Fax
(208) 737-5255
NPI assigned
Aug 4, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9867638-9921 UT
General Practice Dentistry 1223G0001X D-5112 ID Primary

Addresses

Primary practice location

236 River Vista PL Ste 100
Twin Falls, ID 83301-4078

Mailing address

236 River Vista PL Ste 100
Twin Falls, ID 83301-4078
Phone (208) 737-5253

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220524001901 ID Order and Referring Only - DentistPractitioner - Dentist 6204213648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9867638-9921UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services Corporation Dentist Past Accepting new patients
Family Health Services Corporation Dentist Past Accepting new patients
Family Health Services Corporation Dentist Past Accepting new patients
Family Health Services Corporation General Practice Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: thomas.patterson.p1@direct.fhsid.nextgenshare.com

Organizations & group practices 4

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": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1770037038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 RIVER VISTA PL STE 100",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014078",
            "telephone_number": "208-737-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 RIVER VISTA PL STE 100",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014078",
            "telephone_number": "208-737-5253",
            "fax_number": "208-737-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-04",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "9867638-9921",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.