Individual provider Active NPI

Thomas James Vernon, M.D.

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1891056362
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
54311 Issued in AZ
Practice address
1701 E Colter St Unit 240
Phoenix, AZ 85016-3376
Phone
(480) 570-7082
NPI assigned
May 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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 54311 AZ Primary

Addresses

Primary practice location

1701 E Colter St Unit 240
Phoenix, AZ 85016-3376

Mailing address

1701 E Colter St Unit 240
Phoenix, AZ 85016-3376
Phone (480) 570-7082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170802002725 AZ Practitioner - Anesthesiology 6103197660
I20190822004110 WY Practitioner - Anesthesiology 6103197660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Arizona College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyoming Anesthesia, LLCGroup PAC ID 8325383953, 17 clinicians

Practice addresses (Care Compare)

1233 E 2ND St
Casper, WY 82601-2926
Phone (800) 822-7201

Hospital & facility affiliations

  • Banner Wyoming Medical Center Hospital, Casper, WY, CCN 530012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54311AZMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming Anesthesia, LLC Anesthesiology CurrentSince Jun 12, 2019 Accepting new patients
Community Hospital Anesthesiology Current Accepting new patients
Arizona Ketamine Specialists LLC Anesthesiology Past Accepting new patients

Locations

1201 E 3rd St
Casper, WY 82601
Phone (307) 234-4585

1421 Wilkins Cir
Casper, WY 82601
Phone (307) 237-2511

1233 E 2nd St
Casper, WY 82601
Phone (307) 577-2171

4140 Centennial Hills Blvd
Ste C
Casper, WY 82609
Phone (307) 472-8780

2000 Campbell Dr
Torrington, WY 82240
Phone (307) 532-4181

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1891056362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E COLTER ST UNIT 240",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163376",
            "telephone_number": "480-570-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E COLTER ST UNIT 240",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163376",
            "telephone_number": "480-570-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "THOMAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-31",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "54311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.