Keitra Thompson, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8742 Issued in CT

Practice address

64 Black Rock Ave
Bridgeport, CT 06605-1200

Phone

(203) 579-5000

NPI assigned

Jun 15, 2017

Last updated

May 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Optimus Health Care IncGroup PAC ID 9335051580, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kthompson379097@direct.hopkinsmedicine.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  Medicare reassignment Care Compare group NPD
• Familywell PLLC

  • Clinical Social Worker
  • Concord, MA
  • NPI 1396524005

  CT

  Medicare reassignment NPD
• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1669445946
  Care Compare group NPD
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• Family and Medical Counseling Service Inc

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1124363072
  NPD (past)
• Family and Medical Counseling Services

  • Clinical Social Worker
  • Washington, DC
  • NPI 1982097010
  NPD (past)

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589068800000",
    "number": "1063942555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 KNOB HILL DR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BLACK ROCK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051200",
            "telephone_number": "203-579-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5936 Martin Luther King Jr Hwy",
            "address_purpose": "LOCATION",
            "city": "Seat Pleasant",
            "state": "MD",
            "postal_code": "20743",
            "country_code": "US",
            "telephone_number": "202-889-7901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2041 Martin Luther King Jr Ave SE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20020",
            "country_code": "US",
            "telephone_number": "202-889-7901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 N WOLFE STREET",
            "address_2": "RUBENSTEIN BLDG, 2ND FLOOR, SUITE 2096",
            "address_purpose": "LOCATION",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21287",
            "country_code": "US",
            "telephone_number": "443-287-1140",
            "fax_number": "410-550-4141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Grand St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061061541",
            "country_code": "US",
            "telephone_number": "860-550-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KEITRA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2020-05-10",
        "certification_date": "2020-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1050784",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R214567",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRNCNP021660",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orlexia Thomas
• Sumi Varghese Thomas, M.B.B.S
• Tara Thompson-Felix, M.D.
• Ashanee Thompson
• Charles Thompson, MD
• Noel S. Thompson, D.C.
• Jia Yean Thong, M.B.B.S.
• Gianina Thornton, AGNP
• Three 62 Ten Research Group, Inc
• Stephen Francis Thung, MD

• Family Nurse Practitioner in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.