Individual provider Active NPI

Carla D Thomas

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1780187377
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.017290 Issued in IL
Practice address
4055 Valley View LN
Dallas, TX 75244-5074
Phone
(917) 715-3800
NPI assigned
Mar 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.017290 IL Primary

Addresses

Primary practice location

4055 Valley View LN
Dallas, TX 75244-5074

Mailing address

PO Box 208733
Chicago, IL 60620-8733
Phone (312) 203-8217

Other practice location 1

4055 Valley View Ln
Dallas, TX 75244-5074
Phone (917) 715-3800

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL unknown Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190430000565 IL Practitioner - Nurse Practitioner 5597007211 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.017290ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Jul 1, 2025 Accepting new patients
Grow Healthcare Group PA CurrentSince Mar 4, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jul 20, 2023 Accepting new patients
Vpa PC CurrentSince Jul 1, 2025 Accepting new patients

Locations

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

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": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1780187377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208733",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606208733",
            "telephone_number": "312-203-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445074",
            "telephone_number": "917-715-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4055 Valley View Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752445074",
            "country_code": "US",
            "telephone_number": "917-715-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CARLA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.017290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "endpointDescription": "unknown",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "unknown",
            "address_1": "4055 Valley View Ln",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752445074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.