Individual provider Active NPI

Daniel R Thomas, M.D.

  • Anesthesiology Physician
  • West Plains, MO
National Provider Identifier
1780684720
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
21568 Issued in WV
Practice address
1100 N Kentucky Ave
West Plains, MO 65775-2029
Phone
(417) 257-6782
Fax
(417) 257-5916
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 21568 WV Primary

Addresses

Primary practice location

1100 N Kentucky Ave
West Plains, MO 65775-2029

Mailing address

PO Box 1100
West Plains, MO 65775-1100
Phone (417) 257-6782

Other identifiers 4

IdentifierTypeStateIssuer
194781001MedicaidAR
3810000067MedicaidWV
1780684720MedicaidMO
209566504MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120612000656 MO Practitioner - Anesthesiology 2769461417 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21568WVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center CurrentSince Jan 2, 2013 Accepting new patients
Ozarks Medical Center CurrentSince Jan 2, 2013 Accepting new patients
General Anesthesia Services Inc Anesthesiology Past Accepting new patients

Locations

1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1780684720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751100",
            "telephone_number": "417-257-6782",
            "fax_number": "417-257-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N KENTUCKY AVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752029",
            "telephone_number": "417-257-6782",
            "fax_number": "417-257-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "DANIEL",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "21568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194781001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000067",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780684720",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209566504",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.