Individual provider Active NPI

Gregory Boyd Thompson, RPH

  • Pharmacist
  • Traverse City, MI
National Provider Identifier
1053508374
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
530100020114 Issued in MI
Practice address
324 S Union St
Traverse City, MI 49684-2535
Phone
(231) 947-4212
Fax
(231) 947-0301
NPI assigned
Oct 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 530100020114 MI Primary

Addresses

Primary practice location

324 S Union St
Traverse City, MI 49684-2535

Mailing address

324 S Union St
Traverse City, MI 49684-2535
Phone (231) 947-4212

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
530100020114MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1053508374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 S UNION ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842535",
            "telephone_number": "231-947-4212",
            "fax_number": "231-947-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 S UNION ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842535",
            "telephone_number": "231-947-4212",
            "fax_number": "231-947-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "GREGORY",
        "middle_name": "BOYD",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "530100020114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.

Verify at the official NPI Registry.