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General NPI Number Information
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NPI Number | 1962086496
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Entity Type | Organization
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Legal Business Name | THOMAS CARE CLINIC LLC
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 2040 E SUNSHINE ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-1815
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Country | US
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Telephone | 417-275-8900
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Fax | 417-270-8012
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Provider Business Mailing Address
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Address Line | 2040 E SUNSHINE ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-1815
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Country | US
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Telephone | 417-275-8900
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Fax | 417-270-8012
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Authorized Official
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Title or Position | CLINIC OWNER
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Name | ALICIA R THOMAS
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Credential | FNP-BC
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Telephone | 417-275-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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