Individual provider Active NPI

John Kevin Thomas, SPECIALIST

  • Prosthetics Case Management
  • Lakewood, CA
National Provider Identifier
1962123471
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
B78253 Issued in CA
Practice address
61 Lakewood Center Mall Ste J
Lakewood, CA 90712-2417
Phone
(562) 416-1656
NPI assigned
Sep 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X B78253 CA Primary

Addresses

Primary practice location

61 Lakewood Center Mall Ste J
Lakewood, CA 90712-2417

Mailing address

15620 S Normandie Ave Apt J
Gardena, CA 90247-4041
Phone (562) 416-1656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
B78253CAMDProsthetics Case Management

Practice roles

OrganizationSpecialtyStatusNew patients
Jtbundles Salon and Barber CurrentSince Sep 11, 2022 Accepting new patients

Locations

61 Lakewood Center Mall
Ste J
Lakewood, CA 90712
Phone (562) 416-1656

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1962123471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15620 S NORMANDIE AVE APT J",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474041",
            "telephone_number": "562-416-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 LAKEWOOD CENTER MALL STE J",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122417",
            "telephone_number": "562-416-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JOHN",
        "middle_name": "KEVIN",
        "credential": "SPECIALIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "CA",
            "license": "B78253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.