Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Kodie Thomas

Individual provider Physician Assistant · NPI 1003376559

Mr. Kodie Thomas is a Physician Assistant in Emmett, Idaho. Qualified in 2019, 7 years ago. Practices with Quantum Healthcare Medical Associates of Arizona PC, a 36-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
7
Licensed in
AZ
In the registry since
2019
Specialties on file
2

Practice location Address checks out

2086 Picket Ln
Emmett, ID 83617-9104
Phone: (208) 369-1276
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9134 (AZ)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1003376559
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 21, 2019
Last updated in NPPESDecember 2, 2022
Certification dateDecember 2, 2022
Mailing address2086 Picket Ln, Emmett, ID 83617-9104

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Quantum Healthcare Medical Associates Of Arizona Pc — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Emmett