Individual provider Active NPI

Racquel Thompson

  • Community Health Worker
  • Roosevelt, UT
National Provider Identifier
1053975490
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
285 W 800 S
Roosevelt, UT 84066-3707
Phone
(435) 725-6300
Fax
(435) 725-6325
NPI assigned
Apr 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Peer Specialist 175T00000X
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

285 W 800 S
Roosevelt, UT 84066-3707

Mailing address

1140 W 500 S Ste 9
Vernal, UT 84078-2912
Phone (435) 789-6300

Other practice location 1

591 S Knik Goose Bay Rd
Wasilla, AK 99654-8062
Phone (907) 357-8780

Other practice location 2

545 S Knik Goose Bay Rd
Wasilla, AK 99654-8171
Phone (907) 313-1333

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

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1053975490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W 500 S STE 9",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782912",
            "telephone_number": "435-789-6300",
            "fax_number": "435-789-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 W 800 S",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840663707",
            "telephone_number": "435-725-6300",
            "fax_number": "435-725-6325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "591 S Knik Goose Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996548062",
            "country_code": "US",
            "telephone_number": "907-357-8780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "545 S Knik Goose Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996548171",
            "country_code": "US",
            "telephone_number": "907-313-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "RACQUEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-30",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.