MISS TAMARA IDETTE THORN (NPI# 1548320823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548320823 |
| Entity Type | Individual |
| Full Name | MISS TAMARA IDETTE THORN |
| Credential | MSW, LCSW, PA-C |
| Practice Address |
4645 Samuell Blvd Metrocare Services Dallas TX 75228-6826 |
| Practice Telephone | 2147431200 |
| Mailing Telephone | 7048204933 |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2011-08-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
8654 | SC | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
C004844 | NC | Behavioral Health & Social Service Providers |
| Y | 363A00000X | Physician Assistant | PA07340 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 005697 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
005697 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6003179 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053606152 | Tamara Kay Thorn | Nurse Practitioner | 5348 Lamme Rd, Moraine, OH 45439-3215 | 2011-06-16 |
| Street Address |
4645 SAMUELL BLVD METROCARE SERVICES |
| City | DALLAS |
| State | TX |
| Zip Code | 75228-6826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720001118 | Kristen H Grable | Psychiatry & Neurology | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2006-07-26 |
| 1710587845 | Ijeoma Agolue | Nurse Practitioner | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2020-10-28 |
| 1144883414 | Trendolyn Desha Davis | Counselor | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2019-04-22 |
| 1659842987 | Caroline Moraa Tomlinson | Nurse Practitioner | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2018-12-16 |
| 1487122073 | Stanley Imoleayo Okeyemi | Nurse Practitioner | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2018-11-13 |
| 1720593981 | Kemi Fawehinmi | Nurse Practitioner | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2017-12-11 |
| 1689124125 | Latifat Adelekan-adeogun | Nurse Practitioner | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2016-10-07 |
| 1730554890 | Derica Perez | Nurse Practitioner | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2015-12-01 |
| 1396172631 | Raigina Lenette Preston | Nurse Practitioner | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2013-10-01 |
| 1811240013 | Metrocare | Clinic/Center | 4645 Samuell Blvd, Dallas, TX 75228-6826 | 2012-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437625092 | Le Reve Rehab & Mc LLC | Skilled Nursing Facility | 3309 Dilido Road, Dallas, TX 75228 | 2018-10-22 |
| 1083905053 | R2j Investments LLC | Pharmacy | 6300 Samual Blvd, Ste #118, Dallas, TX 75228 | 2011-04-26 |
| 1376709493 | Rupen Suresh Amin | Family Medicine | 2360 Gus Thomasson Rd, Dallas, TX 75228 | 2008-07-29 |
| 1356512453 | Affirm Healthcare, LLC | Home Health | 10950 Woodmeadow Pkwy, #223, Dallas, TN 75228 | 2008-03-17 |
| 1629280110 | Shining Star Home Health Care Inc | Home Health | 8344 East R L Thronton Fwy, Ste # 203, Dallas, TX 75228 | 2007-05-04 |
| 1922123728 | Federico Maese | Family Medicine | 12601 E. Northwest Hwy, Dallas, TX 75228 | 2007-03-20 |
| 1578602223 | Rob F Smith | Social Worker | 8035 East R L Thornton Freeway, Suite #503, Dallas, TX 75228 | 2007-02-06 |
| 1710037023 | Candace Freeman Mcdaniel | Family Medicine | 8021 East R. L. Thornton Frwy, Suite A, Dallas, TX 75228 | 2007-01-11 |
| 1841376175 | Dana Ray Scott | Dentist | 2335 Gus Thomasson, Dallas, TX 75228 | 2006-10-30 |
| 1255425625 | Optimal Home Health Inc | Home Health | 8344 E R L Thornton Fwy Ste 214, Dallas, TX 75228 | 2006-10-03 |
| Find all providers in zip 75228 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700440 | Heather Weir | Physician Assistant | 7331 Gaston Ave Ste 180, Dallas, TX 75214-4131 | 2020-11-03 |
| 1225643562 | Yermiahu Levi Sarne | Physician Assistant | 6206 Preston Crest Ln, Dallas, TX 75230-1828 | 2020-09-14 |
| 1255945564 | Amanda Michelle Flores | Physician Assistant | 1801 Young St, Dallas, TX 75201 | 2020-09-03 |
| 1275151102 | Kelly Ashworth | Physician Assistant | 7331 Gaston Ave # 180, Dallas, TX 75214-4131 | 2020-07-07 |
| 1780201715 | Gabriela Yvonne Camacho | Physician Assistant | 7331 Gaston Ave Unit 180, Dallas, TX 75214-4131 | 2020-06-25 |
| 1346879699 | Ws Neuroassist, Pllc | Physician Assistant | 7324 Gaston Ave Ste 124-80, Dallas, TX 75214-6126 | 2020-04-07 |
| 1265065122 | Sarah Bell Stewart | Physician Assistant | 7811 Bryn Mawr Dr, Dallas, TX 75225-8217 | 2020-02-19 |
| 1093348237 | Meagan Lee Barry | Physician Assistant | 221 W Colorado Blvd Ste 431, Dallas, TX 75208-2312 | 2020-02-17 |
| 1245863554 | Melissa Ann Johnston | Physician Assistant | 4373 Boca Bay Dr, Dallas, TX 75244-7408 | 2020-02-14 |
| 1205479607 | Mj Surgical, Pllc | Physician Assistant | 1408 N Riverfront Blvd # 906, Dallas, TX 75207-3912 | 2019-10-18 |
| Find all providers in DALLAS | ||||
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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.