Healthcare Provider Details

I. General information

NPI: 1396699716
Provider Name (Legal Business Name): THOMAS CARE CLINIC SPECIALTY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 E SUNSHINE ST
SPRINGFIELD MO
65804-1815
US

IV. Provider business mailing address

2060 E SUNSHINE ST
SPRINGFIELD MO
65804-1815
US

V. Phone/Fax

Practice location:
  • Phone: 417-275-8900
  • Fax: 417-270-8012
Mailing address:
  • Phone: 417-275-8900
  • Fax: 417-270-8012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ALICIA R THOMAS
Title or Position: MEMBER
Credential: FNP-BC
Phone: 417-275-8900