Provider Demographics
NPI:1316941941
Name:NIGRO, THOMAS LEE (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEE
Last Name:NIGRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11816 W 112TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1372
Mailing Address - Country:US
Mailing Address - Phone:913-663-3277
Mailing Address - Fax:913-339-6605
Practice Address - Street 1:10500 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:913-663-3277
Practice Address - Fax:913-339-6605
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9990174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO10785019 08163049OtherBLUE CROSS BLUE SHIELD
MO501985709Medicaid
MO009820OtherFAMILY HEALTH PARTNERS
KS100427050-AMedicaid
KS100427050-AMedicaid
MO501985709Medicaid