Jessica Thoman

Primary specialty

SpecialistTaxonomy code 174400000X

License

1183303171 Issued in NY

Practice address

40 Henrietta Blvd
Amsterdam, NY 12010-1111

Phone

(518) 843-3003

NPI assigned

Dec 6, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1942715453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "FORT HUNTER",
            "state": "NY",
            "postal_code": "120690088",
            "telephone_number": "607-765-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HENRIETTA BLVD",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120101111",
            "telephone_number": "518-843-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAN",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1183303171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1183303171",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Amsterdam, NY
• Providers in Amsterdam, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.