Individual provider Active NPI

David Gerard Thompson, M.D.

  • Cardiovascular Disease Physician
  • Ottawa, IL
National Provider Identifier
1063673515
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036-120454 Issued in IL
Practice address
1050 E Norris Dr
Ste 2C
Ottawa, IL 61350-1605
Phone
(815) 434-0276
Fax
(815) 434-0319
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.120454 IL
Cardiovascular Disease Physician 207RC0000X 036-120454 IL Primary

Addresses

Primary practice location

1050 E Norris Dr
Ste 2C
Ottawa, IL 61350-1605

Mailing address

1050 E Norris Dr
Ste 2C
Ottawa, IL 61350-1605
Phone (815) 434-0276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000278 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3870762537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1050 E Norris Dr
Suite 2C
Ottawa, IL 61350-1611
Phone (815) 434-0276

Hospital & facility affiliations

  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
  • Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Osf Saint Paul Medical Center Hospital, Mendota, IL, CCN 141310
  • Saint James Hospital Hospital, Pontiac, IL, CCN 140161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.120454ILMDInternal Medicine Physician
036-120454ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Heartcare Midwest , LTD Cardiovascular Disease Past Accepting new patients

Locations

1050 E Norris Dr
Ste 2C
Ottawa, IL 61350
Phone (815) 431-0785

1050 E Norris Dr
Ste 1B
Ottawa, IL 61350
Phone (815) 434-0276

610 Park Ave
Pekin, IL 61554
Phone (309) 346-7776

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5405 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-4410

920 West St
Ste B
Peru, IL 61354
Phone (815) 223-2944

530 Park Ave E
Ste 303A
Princeton, IL 61356
Phone (815) 876-3179

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1063673515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 E NORRIS DR",
            "address_2": "STE 2C",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501605",
            "telephone_number": "815-434-0276",
            "fax_number": "815-434-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E NORRIS DR",
            "address_2": "STE 2C",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501605",
            "telephone_number": "815-434-0276",
            "fax_number": "815-434-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DAVID",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.120454",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-120454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

Verify at the official NPI Registry.