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Deactivated NPI 1104356690 Deactivated / Inactive NPI Female Practitioner

Kathy Darlene Thomas , REV

Peer Specialist • Broken Arrow, OK

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kathy Thomas has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 15, 2017
NPI Deactivation Date April 09, 2026
Total Practice Duration ~9 Years of Practice (2017 – 2026)

Professional Overview & Biography Verified Profile Summary

Kathy Thomas, REV was a registered Peer Specialist practicing in Broken Arrow, OK. Throughout an active medical career spanning 9 years, Kathy Thomas provided care at the practice location at 4408 N 35TH ST until profile deactivation on 2026-04-09.

Practice Location & Contact Primary Location

Practice Address

4408 N 35th St

Broken Arrow, OK 740148845

Telephone 9185196721
Fax 9189407411

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Broken Arrow, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
50 Specialists

Practicing in Broken Arrow, OK (5280 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 09, 2026

Record deactivated on April 09, 2026

NPI Profile Active June 15, 2017

NPI status registered as active in NPPES database

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Updated Practice Location June 15, 2017

Registered at 4408 N 35TH ST, BROKEN ARROW, OK 740148845 (Tel: 9185196721)

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Updated Business Mailing Address June 15, 2017

Registered at 4408 N 35TH ST, BROKEN ARROW, OK 740148845 (Tel: 9185196721)

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Provider Name / Credentials Updated June 15, 2017

Recorded as KATHY THOMAS, REV

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2017

Peer Specialist

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Initial NPI Registration & Enumeration June 15, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104356690
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 15, 2017
Last Update: June 15, 2017
Deactivation Date: April 09, 2026

Mailing Address

4408 N 35th St

Broken Arrow, OK 740148845

Phone: 9185196721

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.