Individual provider Active NPI

Cherie Alta Thomas, M.D.

  • Family Medicine Physician
  • Benson, AZ
National Provider Identifier
1982683645
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27014 Issued in AZ
Practice address
890 W 4TH St
Benson, AZ 85602-6437
Phone
(520) 586-3664
Fax
(520) 586-3486
NPI assigned
Jan 11, 2006
Last updated
Apr 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 33692 WI
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X MD-9100 HI
Family Medicine Physician 207Q00000X 27014 AZ Primary

Addresses

Primary practice location

890 W 4TH St
Benson, AZ 85602-6437

Mailing address

1003 Old Kings Rd
Holly Hill, FL 32117-3024
Phone (386) 307-8731

Other identifiers 1

IdentifierTypeStateIssuer
33692OtherWIWI STATE LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 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
I20140520002469 TX Practitioner - Family Practice 9931186517 Reassigns benefits to 1 organization
I20170324002114 AZ Practitioner - Emergency Medicine 9931186517 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33692WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Band of Choctaw Indians CurrentSince Apr 8, 2014 Accepting new patients
Benson Hospital Corporation CurrentSince Nov 1, 2020 Accepting new patients
Benson Hospital Corporation CurrentSince Nov 1, 2020 Accepting new patients
Mississippi Band of Choctaw Indians CurrentSince Apr 8, 2014 Accepting new patients
Mississippi Band of Choctaw Indians Current Accepting new patients
Marshfield Clinic Inc Current Accepting new patients
Neuse River Emergency Physicians Emergency Medicine Past Accepting new patients
Bladen County Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Sparta Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

450 S Ocotillo St
Benson, AZ 85602
Phone (520) 586-2261

890 W 4th St
Benson, AZ 85602
Phone (520) 586-3664

210 Hospital Cir
Choctaw, MS 39350
Phone (601) 389-4500

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257

Interoperability endpoints

  • Direct secure messaging: cherie.thomas@hawaiihie.medicity.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1982683645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 OLD KINGS RD",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321173024",
            "telephone_number": "386-307-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W 4TH ST",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "856026437",
            "telephone_number": "520-586-3664",
            "fax_number": "520-586-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CHERIE",
        "middle_name": "ALTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "33692",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "HI",
            "license": "MD-9100",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "27014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LIC",
            "identifier": "33692",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benson, AZ

Sources for this page

Verify at the official NPI Registry.