Individual provider Active NPI

Christian Jay Thompson, O.D., F.A.A.O.

  • Optometrist
  • Winslow, AZ
National Provider Identifier
1013912534
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002229 Issued in AZ
Practice address
500 Indiana Ave
Winslow, AZ 86047-2169
Phone
(928) 245-3732
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001678 VA
Optometrist 152W00000X OPT-002229 AZ Primary
Optometrist 152W00000X 2756 OK
Optometrist 152W00000X OEG003082 PA

Addresses

Primary practice location

500 Indiana Ave
Winslow, AZ 86047-2169

Mailing address

5069 S Amethyst Rd
Flagstaff, AZ 86005-6840
Phone (928) 245-3732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090115000381 TX Practitioner - Optometry 1052474111 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Indiana Ave
Winslow, AZ 86047-2169

500 N Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

SWC Navajo Route 15 and 60
1 Medical Center Dr
Dilkon, AZ 86047-2169
Phone (928) 289-4646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002229AZMDOptometrist
OEG003082PAMDOptometrist
2756OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc CurrentSince May 30, 2017 Accepting new patients
Kayenta Alternative Rural Hospital CurrentSince Oct 17, 2016 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince May 30, 2017 Accepting new patients
Dilkon Medical Center Current Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients

Locations

500 Indiana Ave
Winslow, AZ 86047

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1013912534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5069 S AMETHYST RD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860056840",
            "telephone_number": "928-245-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 INDIANA AVE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472169",
            "telephone_number": "928-245-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CHRISTIAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "O.D., F.A.A.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001678",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002229",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2756",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003082",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winslow, AZ

Sources for this page

Verify at the official NPI Registry.