MEDICARE: DR. ROBERT BENEDICT THOMA D.C., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104000576	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	076212	OTHER	VA	BLUE CROSS BLUE SHIELD
2	52788	OTHER	VA	OPTIMA
3	541356929	OTHER	VA	TAX ID

General Provider Information

NPI Number	:	1639244841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT BENEDICT THOMA D.C., P.C.

Provider Business Mailing Address
First Line	:	2244 SUNSTATES CT
Second Line	:	SUITE 104
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1552
Country	:	US
Telephone Number	:	757-481-5444
Fax Number	:	757-481-0048

Provider Business Practice Location Address
First Line	:	2244 SUNSTATES CT
Second Line	:	SUITE 104
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1552
Country	:	US
Telephone Number	:	757-481-5444
Fax Number	:	757-481-0048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	02/12/2026

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