Individual provider Active NPI

Amanda Lyn Thomas, MD

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1962667592
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25138 Issued in OK
Practice address
309 S Ann Arbor Ave
Oklahoma City, OK 73128-1112
Phone
(405) 948-4900
Fax
(405) 948-4933
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25138 OK Primary

Addresses

Primary practice location

309 S Ann Arbor Ave
Oklahoma City, OK 73128-1112

Mailing address

4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone (405) 948-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 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
I20090917000297 OK Practitioner - Family Practice 1557417425 Reassigns benefits to 1 organization
I20240322000137 TX Practitioner - Family Practice 1557417425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Oklahoma American Indian Health Council, Inc.Group PAC ID 3476617374, 60 clinicians

Practice addresses (Care Compare)

5208 W Reno Ave
Oklahoma City Indian Clinic
Oklahoma City, OK 73128-1112
Phone (405) 948-4900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25138OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Apr 24, 2023 Accepting new patients
Central Oklahoma American Indian Health Council, Inc. CurrentSince May 1, 2024 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

2916 N Kelly Ave
Edmond, OK 73003
Phone (405) 713-5300

1401 SW 34th St
Ste 200
Moore, OK 73160
Phone (405) 793-1188

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

309 S Ann Arbor Ave
Oklahoma City, OK 73128
Phone (405) 948-4900

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

4913 W Reno Ave
Oklahoma City, OK 73127
Phone (405) 948-4900

5208 W Reno Ave
Oklahoma City, OK 73127
Phone (405) 948-4900

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.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1962667592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731276339",
            "telephone_number": "405-948-4900",
            "fax_number": "405-948-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S ANN ARBOR AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731281112",
            "telephone_number": "405-948-4900",
            "fax_number": "405-948-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "AMANDA",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "25138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.