Active NPI
Gary M Thompson, DMD
- Dentist
- Stanton, KY
National Provider Identifier
1003897273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4473
- Practice address
- 131 N Main St
Stanton, KY 40380-2174 - Phone
- (606) 663-2133
- Fax
- (606) 663-0699
- NPI assigned
- Nov 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4473 | KY | Primary |
Addresses
Primary practice location
131 N Main St
Stanton, KY 40380-2174
Mailing address
889 Boone Creek Rd
Stanton, KY 40380-9435
Phone (606) 663-2133
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4730 | Other | KY | DELTA DENTAL OF KENTUCKY |
| Y945 | Other | KY | BLUE CROSS-BLUE SHIELD |
| 60044732 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4473 | KY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1003897273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "889 BOONE CREEK RD",
"city": "STANTON",
"state": "KY",
"postal_code": "403809435",
"telephone_number": "606-663-2133",
"fax_number": "606-663-0699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 N MAIN ST",
"city": "STANTON",
"state": "KY",
"postal_code": "403802174",
"telephone_number": "606-663-2133",
"fax_number": "606-663-0699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "GARY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-07",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "4473",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL OF KENTUCKY",
"identifier": "4730",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-BLUE SHIELD",
"identifier": "Y945",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60044732",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stanton, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.