Active NPI
Jeffrey D Thompson, MD
- Pediatrics Physician
- Memphis, TN
National Provider Identifier
1023005535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD35723
- Practice address
- 1129 Hale Rd
Memphis, TN 38116-6373 - Phone
- (901) 396-0390
- Fax
- (901) 396-3728
- NPI assigned
- Sep 29, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD35723 | TN | Primary |
| Pediatrics Physician | 208000000X | MD18396 | MS |
Addresses
Primary practice location
1129 Hale Rd
Memphis, TN 38116-6373
Mailing address
1129 Hale Rd
Memphis, TN 38116-6373
Phone (901) 396-0390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3495461 | Medicaid | TN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD18396 | MS | MD | Pediatrics Physician |
| MD35723 | TN | MD | Pediatrics Physician |
| 35723 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memphis Children'S Clinic, PLLC | Pediatrics | Past | Accepting new patients |
| Baptist Memorial Hospital | Past | Accepting new patients | |
| Memphis Children'S Clinic,PLLC | Pediatrics | Past | Accepting new patients |
| Methodist Healthcare - Memphis Hospitals | Past | Accepting new patients | |
| Memphis Children'S Clinic, PLLC | Pediatrics | Past | Accepting new patients |
| Methodist Healthcare - Memphis Hospitals | Past | Accepting new patients |
Networks
- MS PPO D-SNP
- MS PPO C-SNP
- MS PPO
- LA PPO C-SNP
Interoperability endpoints
- jthompson@linux.pcc-direct.com
- jthompson27927@mlh.direct-ci.com
Organizations & group practices 6
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.
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1578527172
-
- Pediatrics Physician
- Bartlett, TN
- NPI 1477633303
-
- Community/Retail Pharmacy
- Memphis, TN
- NPI 1225723133
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Memphis, TN
- NPI 1245383355
-
- Pediatrics Physician
- Southaven, MS
- NPI 1790865616
-
- Pediatrics Physician
- Olive Branch, MS
- NPI 1649450909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023005535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1129 HALE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166373",
"telephone_number": "901-396-0390",
"fax_number": "901-396-3728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1129 HALE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166373",
"telephone_number": "901-396-0390",
"fax_number": "901-396-3728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "JEFFREY",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "MD35723",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "MD18396",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3495461",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.