Mavis Thomas, NURSE PRACTITIONER

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

0024170372 Issued in VA

Practice address

620 John Paul Jones Cir
Portsmouth, VA 23708

Phone

(757) 953-5008

NPI assigned

Oct 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1922352913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082197",
            "telephone_number": "757-953-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708",
            "telephone_number": "757-953-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MAVIS",
        "name_prefix": "Prof.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "VA",
            "license": "0024170372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa'-Venia, LLC (Corine's Place)
• Alesha April Thomas, LMT
• Denisia Nesha Thomas
• Francis M Thomas, IDC
• Mark Allen Thomas, NP
• Shauna Speede Thomas, FNP-BC
• Jamie Morgan Thompson
• Kristin Thompson, PT, DPT, MS
• Lindon Hugh Thompson
• Matthew Thompson

• Adult Psychiatric/Mental Health Registered Nurse in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.