Active NPI
Donovan Lee Thomas, DC
- Chiropractor
- Kyle, TX
National Provider Identifier
1861417529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC6919
- Practice address
- 187 Elmhurst
Ste B
Kyle, TX 78640-6116 - Phone
- (512) 398-2143
- Fax
- (512) 887-4706
- NPI assigned
- Jul 13, 2006
- Last updated
- Jun 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC6919 | TX | Primary |
Addresses
Primary practice location
187 Elmhurst
Ste B
Kyle, TX 78640-6116
Mailing address
187 Elmhurst
Ste B
Kyle, TX 78640-6116
Phone (512) 398-2143
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001885501 | Medicaid | TX | |
| 605333 | Other | TX | BCBS TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040525001240 | TX | Practitioner - Chiropractic | 7719968973 | Practice locations: Kyle, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC6919 | TX | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Texas Welllness Center, L.L.C. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lockhart Rehab & Wellness Center
- Chiropractor
- Lockhart, TX
- NPI 1124297254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1861417529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "187 ELMHURST",
"address_2": "STE B",
"city": "KYLE",
"state": "TX",
"postal_code": "786406116",
"telephone_number": "512-398-2143",
"fax_number": "512-887-4706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "187 ELMHURST",
"address_2": "STE B",
"city": "KYLE",
"state": "TX",
"postal_code": "786406116",
"telephone_number": "512-398-2143",
"fax_number": "512-887-4706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "DONOVAN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "DC6919",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001885501",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TX",
"identifier": "605333",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kyle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.