Active NPI
Racquel Thompson
- Community Health Worker
- Roosevelt, UT
National Provider Identifier
1053975490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.