Healthcare Provider Details

I. General information

NPI: 1992639082
Provider Name (Legal Business Name): KAMISHA THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 ARLINGTON AVE
COLUMBUS OH
43211-1551
US

IV. Provider business mailing address

1629 ARLINGTON AVE
COLUMBUS OH
43211-1551
US

V. Phone/Fax

Practice location:
  • Phone: 614-260-2990
  • Fax:
Mailing address:
  • Phone: 614-260-2990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.007304
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: