Individual provider Active NPI

Kelly S Thompson, D.C.

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1033114665
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3988 Issued in AZ
Practice address
2815 S Alma School Rd
Ste 126
Mesa, AZ 85210-4003
Phone
(480) 839-0221
Fax
(480) 839-9146
NPI assigned
Jun 20, 2005
Last updated
Jan 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3988 AZ Primary

Addresses

Primary practice location

2815 S Alma School Rd
Ste 126
Mesa, AZ 85210-4003

Mailing address

2815 S Alma School Rd
Ste 126
Mesa, AZ 85210-4003
Phone (480) 839-0221

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3988AZMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1033114665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 S ALMA SCHOOL RD",
            "address_2": "STE 126",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104003",
            "telephone_number": "480-839-0221",
            "fax_number": "480-839-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 S ALMA SCHOOL RD",
            "address_2": "STE 126",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104003",
            "telephone_number": "480-839-0221",
            "fax_number": "480-839-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KELLY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "3988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.