CLARENCE H THOMAS MD LLC (NPI# 1619074812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619074812 |
| Entity Type | Organization |
| Organization Name | CLARENCE H THOMAS MD LLC |
| Practice Address |
6021 Kentucky Avenue Indianapolis IN 46221 |
| Mailing Address |
6021 Kentucky Ave Indianapolis IN 46221-9701 |
| Practice Telephone | 3178565565 |
| Practice Fax Number | 3178561202 |
| Mailing Telephone | 3178565565 |
| Mailing Fax Number | 3178561202 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-03-26 |
| Authorized Official Name | CLARENCE HENRY THOMAS (OWNER) |
| Authorized Official Telephone | 3178565565 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000384605 | 01 |
| IN | 200365090 | 05 |
| Street Address |
6021 KENTUCKY AVENUE |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215019401 | Carol June Kauffman | Nurse Practitioner | 6021 Kentucky Avenue, Indianapolis, IN 46221 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598957474 | Kim M Malicoat | Occupational Therapy Assistant | 5019 Emmert Drive, Indianapolis, IN 46221 | 2007-08-14 |
| 1811066715 | Sarah A Wilson | Dentist | 3715 Kentucky Av, Suite B, Indianapolis, IN 46221 | 2006-11-06 |
| 1356326763 | Clarence Henry Thomas | Family Medicine | 6021 Kentucky Ave, Indianapolis, IN 46221 | 2005-12-08 |
| 1740443027 | Stacey Anne Ulery | Physical Therapy Assistant | 4851 Tincher Rd, Indianapolis, IN 46221 | 2008-07-07 |
| 1922096734 | William Vanosdol | Pediatrics | 2202 W Morris St, Indianapolis, IN 46221-1404 | 2005-10-06 |
| 1447644638 | Peter Rentsch | Specialist/Technologist | 1336 Shepard St, Indianapolis, IN 46221-1528 | 2015-03-25 |
| 1881681682 | Kathleen Anne Cohenour | Internal Medicine | 1522 W Morris St, Indianapolis, IN 46221-1629 | 2005-10-05 |
| 1053956987 | Tracy L Morrison | Nurse Practitioner | 1522 W Morris St, Indianapolis, IN 46221-1629 | 2019-11-14 |
| 1922544584 | Lori S. Fishburn | Nurse Practitioner | 1522 W Morris St, Indianapolis, IN 46221-1629 | 2017-01-06 |
| 1689128050 | Roshni Shah | Pharmacist | 1522 W Morris St, Indianapolis, IN 46221-1629 | 2016-08-15 |
| Find all providers in zip 46221 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073125225 | Relymd Medical Group In, LLC | Family Medicine | 9221 Crawfordsville Rd, Indianapolis, IN 46234-1521 | 2020-08-19 |
| 1134765993 | Basil Vareldzis | Family Medicine | 9125 Nautical Watch Dr, Indianapolis, IN 46236-9036 | 2019-11-26 |
| 1366084329 | Rebekah Venable | Family Medicine | 5455 W 86th St Ste 210, Indianapolis, IN 46268-1530 | 2019-10-11 |
| 1710455738 | Physicians Wellness Associates LLC | Family Medicine | 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 | 2018-11-07 |
| 1386150043 | Brengle Family Medicine | Family Medicine | 8803 N Meridian St Ste 350, Indianapolis, IN 46260-5386 | 2017-12-18 |
| 1164937249 | Amy Cheung | Family Medicine | 6484 N Chester Ave, Indianapolis, IN 46220-4422 | 2017-12-11 |
| 1578017182 | Medical Specialty LLC | Family Medicine | 2301 N Meridian St, Indianapolis, IN 46208-5729 | 2016-08-11 |
| 1245685742 | Christopher Basom | Family Medicine | 8501 E 56th St Ste 120, Indianapolis, IN 46216-2118 | 2016-05-03 |
| 1760846877 | Catherine Gambale Trigonis | Family Medicine | 404 E Washington St Ste A, Indianapolis, IN 46204 | 2016-04-06 |
| 1205204203 | Community Health Network | Family Medicine | 1643 E Hanna Ave, Ste 108, Indianapolis, IN 46227-3655 | 2015-09-08 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46221 |
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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.