Provider Demographics
NPI:1669418935
Name:THOMAS, SHEILA B (DO)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:B
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SHEILA
Other - Middle Name:BENITIA
Other - Last Name:TRIPLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9820 WESTPOINT DR STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3362
Mailing Address - Country:US
Mailing Address - Phone:317-253-7795
Mailing Address - Fax:317-253-7798
Practice Address - Street 1:9820 WESTPOINT DR STE 500
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3362
Practice Address - Country:US
Practice Address - Phone:317-253-7795
Practice Address - Fax:317-253-7798
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1591207Q00000X
OK3996207Q00000X
IN02003529A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200953660Medicaid
IN000000632929OtherANTHEM
TNI14662Medicare UPIN
INM400068558Medicare PIN
IN719300FFMedicare PIN
IN200953660Medicaid