Individual provider Active NPI

Eric Gregory Thompson, DPT

  • Specialist
  • Boise, ID
National Provider Identifier
1063514867
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT-2078 Issued in ID
Practice address
5418 N Eagle Rd
Ste 140
Boise, ID 83713-0998
Phone
(208) 938-5255
Fax
(208) 938-5545
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT-2078 ID Primary

Addresses

Primary practice location

5418 N Eagle Rd
Ste 140
Boise, ID 83713-0998

Mailing address

5418 N Eagle Rd
Ste 140
Boise, ID 83713-0998
Phone (208) 938-5255

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
PT-2078IDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabauthority, LLC PastSince Sep 19, 2016 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063514867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5418 N EAGLE RD",
            "address_2": "STE 140",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130998",
            "telephone_number": "208-938-5255",
            "fax_number": "208-938-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5418 N EAGLE RD",
            "address_2": "STE 140",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130998",
            "telephone_number": "208-938-5255",
            "fax_number": "208-938-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ERIC",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "PT-2078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

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.

Verify at the official NPI Registry.