Individual provider Active NPI

Donovan Lee Thomas, DC

  • Chiropractor
  • Kyle, TX
National Provider Identifier
1861417529
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC6919 Issued in TX
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, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
001885501MedicaidTX
605333OtherTXBCBS TX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525001240 TX Practitioner - Chiropractic 7719968973 Practice locations: Kyle, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC6919TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.