Thomas H. Nolen, D.P.M., P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016-004182 Issued in IL

Legal business name

THOMAS H. NOLEN, D.P.M., P.C.

Practice address

1313 Main St
Mount Vernon, IL 62864-3720

Phone

(618) 242-8662

Fax

(618) 242-4171

NPI assigned

Nov 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Thomas H. Nolen, D.P.M.NPI 1083602718

Title

President

Phone

(618) 548-0057

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Thomas H. Nolen, D.P.M., P.C.

  • Foot & Ankle Surgery Podiatrist
  • Centralia, IL
  • NPI 1912072968

  O20080521000911

  Same enrollment
• Thomas H. Nolen, D.P.M.,P.C.

  • Foot & Ankle Surgery Podiatrist
  • Salem, IL
  • NPI 1073683637

  O20080521000911

  Same enrollment

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas H. Nolen, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Salem, IL
  • NPI 1083602718
  NPD Authorized official
• Damon Payton, DPM

  • Foot & Ankle Surgery Podiatrist
  • Florissant, MO
  • NPI 1649200502
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1790851665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 W MAIN ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628811403",
            "telephone_number": "618-548-0057",
            "fax_number": "618-548-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 MAIN ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628643720",
            "telephone_number": "618-242-8662",
            "fax_number": "618-242-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS H. NOLEN, D.P.M., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "NOLEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-548-0057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016-004182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD OF ILLINOIS",
            "identifier": "60115194",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004182",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.