Amilie T Thames

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16575 Issued in MS

Practice address

1110 Broad Ave Ste 700
Gulfport, MS 39501-8908

Phone

(228) 864-0314

Fax

(228) 868-8435

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Coastal Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Biloxi, MS
  • NPI 1629066782
  Medicare reassignment NPD
• Coastal Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Lucedale, MS
  • NPI 1427842913
  NPD
• Coastal Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gulfport, MS
  • NPI 1841220357
  NPD
• Inphynet Primary Care Physicians Southeast PC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1770521460
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1851304026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-575-1194",
            "fax_number": "228-575-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BROAD AVE STE 700",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395018908",
            "telephone_number": "228-864-0314",
            "fax_number": "228-868-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMES",
        "first_name": "AMILIE",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "21067",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "16575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000013",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PAYEE MEDICARE NUMBER",
            "identifier": "011846",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PAYEE NPI NUMBER",
            "identifier": "1063439065",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• TD Caremeds Pharmacy LLC
• Mary Kathryn Teal, RD, LD
• Teri L Guyer
• Cinda Cay Terrebonne
• Venessa Terry, RN
• Katherine Thames, FNP
• Scott Thames, DPT
• The Clinic, Therapy & Consulting LLC
• The Dermatology Clinic, PLLC
• The Eye Clinic PA

• Internal Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.