Kisha Denise Thomas, MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

ME137547 Issued in FL

Practice address

7207 Golden Wings Rd Ste 100
Jacksonville, FL 32244-3324

Phone

(904) 389-1010

Fax

(904) 389-1082

NPI assigned

Apr 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, NM2 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

Specialty

Anesthesiology

Education

University of Wisconsin School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Modern Pain and Spine PCGroup PAC ID 7911318068, 5 clinicians

Riverside Spine and Pain Physicians LLCGroup PAC ID 9931092814, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kisha.thomas.p1@direct.riversidepain.nextgenshare.com

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.

• Riverside Spine & Pain Physicians, LLC

  • Specialist
  • Jacksonville, FL
  • NPI 1639208648
  Medicare reassignment Care Compare group NPD
• Modern Pain & Spine PC

  • Interventional Pain Medicine Physician
  • Albuquerque, NM
  • NPI 1821695081
  Medicare reassignment Care Compare group NPD
• Riverside Spine & Pain Physicians, LLC

  • Specialist
  • Jacksonville, FL
  • NPI 1619343886
  NPD
• Modern Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Albuquerque, NM
  • NPI 1922943224
  NPD (past)

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1962728915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-935-8902",
            "fax_number": "765-983-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7207 GOLDEN WINGS RD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322443324",
            "telephone_number": "904-389-1010",
            "fax_number": "904-389-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KISHA",
        "middle_name": "DENISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01075431A",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME137547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000947766",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201305360",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaci Hollenbacher Thomas
• Kathryn Lemaire Thomas, ARNP
• Katrina D Thomas, BUSINESS/ OPERATOR
• Kelsey Alexandra Thomas, OD
• Kimialeesha Thomas, FNP
• Kiyah Noema Thomas
• Koshanna Thomas
• Latrena M Thomas
• Lauren Thomas, RD
• Lawanda Thomas, LMFT

• Pain Medicine (Anesthesiology) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pain Medicine (Anesthesiology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.