SCOTT G THOMAS (NPI# 1033196126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033196126 |
| Entity Type | Individual |
| Full Name | SCOTT G THOMAS |
| Credential | MD |
| Practice Address |
621 Memorial Dr Suite 502 South Bend IN 46601-1063 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 5746475875 |
| Practice Fax Number | 5746475878 |
| Mailing Telephone | 5746471610 |
| Mailing Fax Number | 5742376069 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2016-08-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
01037023A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM BCBS | 000000901457 | 01 |
| IN | 100338820 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003235292 | Scott Warren Thomas | Pediatrics | 1401 Matthews Township Pkwy Ste 100, Matthews, NC 28105-5403 | 2014-04-15 |
| 1407285182 | Scott Thomas | Physical Therapy Assistant | 49 Smith Ln, Marquette, MI 49855-9352 | 2013-11-04 |
| 1144661729 | Scott William Thomas | Counselor | 1814 S Main St, Broken Arrow, OK 74012-6503 | 2013-07-11 |
| 1144574088 | Scott Eugene Thomas | Occupational Therapist | 15525 Adlong Dr, Roanoke, TX 76262-3315 | 2012-10-30 |
| 1841568425 | Scott P Thomas | Family Medicine | 151 S Sunrise Way Ste 300, Palm Springs, CA 92262 | 2011-12-09 |
| 1063664894 | Scott E Thomas | Anesthesiology | 313 Chapman Loop, Pawleys Island, SC 29585-7630 | 2008-10-10 |
| 1619133402 | Scott R Thomas | Counselor | 90 Southside Ave Ste 150, Asheville, NC 28801 | 2008-08-01 |
| 1174748768 | Scott A Thomas | Specialist/Technologist | 600 Summerland Ave, Batesburg-leesville, SC 29006-1429 | 2007-04-17 |
| 1811089915 | Scott Thomas | Physical Medicine & Rehabilitation | 20 Medical Campus Drive, Suite 204 Brunswick Medical Campus, Supply, NC 28422 | 2006-09-28 |
| 1144237975 | Scott D Thomas | Family Medicine | 4971 W Overland Rd, Boise, ID 83705-2822 | 2006-08-02 |
| Street Address |
621 MEMORIAL DR SUITE 502 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003818212 | John L Jenkins | Specialist | 621 Memorial Dr, Ste 502, South Bend, IN 46601-1075 | 2005-06-01 |
| 1447783188 | Khonnah Weithers | Nurse Practitioner | 621 Memorial Dr, Suite 512, South Bend, IN 46601-1063 | 2017-04-10 |
| 1619388717 | Sarah Ann Holewczynski | Registered Nurse | 621 Memorial Dr, Ste 617, South Bend, IN 46601-1063 | 2014-05-12 |
| 1518302264 | Beacon Medical Group, Inc. | Nurse Practitioner | 621 Memorial Dr, Suite 602, South Bend, IN 46601-1063 | 2013-05-08 |
| 1255620985 | David L. Clayton Md Inc | Family Medicine | 621 Memorial Dr, Suite 624, South Bend, IN 46601-1063 | 2011-04-04 |
| 1477873644 | Rebecca M Castro | Nurse Practitioner | 621 Memorial Dr, Ste 502, South Bend, IN 46601-1063 | 2010-06-10 |
| 1508191768 | Allied Physicians of Michiana, LLC | Surgery | 621 Memorial Dr, Suite 302, South Bend, IN 46601-1063 | 2009-10-06 |
| 1841434354 | Kelly Elizabeth Mortell | Radiology | 621 Memorial Dr, Ste 312, South Bend, IN 46601-1063 | 2009-04-28 |
| 1659543643 | William Hanley | Nurse Practitioner | 621 Memorial Dr, Suite 502, South Bend, IN 46601-1063 | 2008-03-31 |
| 1134262595 | North Central Neurology, LLC | Psychiatry & Neurology | 621 Memorial Dr, Suite 624, South Bend, IN 46601-1063 | 2007-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
| 1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
| 1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
| 1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
| 1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
| 1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
| 1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
| 1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
| Find all providers in zip 46601 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649468364 | South Bend Vein Center for Excelllence, LLC | Surgery | 2025 Edison Rd, South Bend, IN 46637-5599 | 2007-10-09 |
| 1497732556 | Thomas L Poulin | Surgery | 100 Navarre Pl Ste 5500, South Bend, IN 46601-1172 | 2005-12-29 |
| 1124553839 | Total Vein Solutions P.c | Surgery | 3015 Mishawaka Ave, South Bend, IN 46615-2347 | 2017-05-01 |
| 1215914452 | George B Friend | Surgery | 621 Memorial Dr, South Bend, IN 46601-1063 | 2005-12-29 |
| 1285611442 | Timothy W Noveroske | Surgery | 621 Memorial Dr, South Bend, IN 46601-1064 | 2005-12-29 |
| 1740267822 | General & Vascular Surgery PC | Surgery | 621 Memorial Dr, South Bend, IN 46601-1064 | 2005-12-29 |
| 1326025495 | Charles E Peterson | Surgery | 621 Memorial Dr, South Bend, IN 46601-1064 | 2005-12-29 |
| 1134106297 | Michael C Rotkis | Surgery | 621 Memorial Dr, South Bend, IN 46601-1064 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801456603 | Wickel Vascular Surgery & Medicine PC | Surgery | 1919 State St Ste 444, New Albany, IN 47150-6809 | 2019-06-14 |
| 1154832178 | Allied Physicians of Michiana, LLC | Surgery | 611 E Douglas Rd Ste 308, Mishawaka, IN 46545-1465 | 2017-10-17 |
| 1194041764 | Andrew Alexander Gonzalez | Surgery | 1801 N Senate Blvd Ste 3500, Indianapolis, IN 46202-1184 | 2010-04-08 |
| 1396938031 | Peripheral Vascular Care | Surgery | 640 S Walker St, Bloomington, IN 47403-2158 | 2007-08-27 |
| 1285841502 | Decatur Vein Clinic Hobart, PC | Surgery | 5043 E Lincoln Hwy, Merrillville, IN 46410-5912 | 2007-05-17 |
| 1093881385 | Decatur Vein Clinic, Michigan, PC | Surgery | 645 W Carmel Dr, Suite 101, Carmel, IN 46032-2605 | 2006-11-28 |
| 1962508853 | Indiana Phlebology PC | Surgery | 371 E 84th Dr Ste 371, Merrillville, IN 46410-6484 | 2006-09-16 |
| 1447361928 | The Heart and Vascular Clinic, P.C. | Surgery | 3251 Shawnee Drive South, Bedford, IN 47421 | 2006-08-31 |
| 1487761607 | Abdolaziz M Ardalan | Surgery | 9737 Decatur Dr, Indianapolis, IN 46256-9656 | 2006-08-24 |
| 1851315618 | William R Finkelmeier | Surgery | 13450 N Meridian St Ste 160, Carmel, IN 46032-1552 | 2006-07-26 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.