Shannakay Juddian Thompson-White

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ01374700 Issued in NJ

Practice address

1205 Shelmire Ave
Philadelphia, PA 19111-2726

Phone

(856) 392-9900

NPI assigned

Jul 19, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complete Care of South JerseyGroup PAC ID 8820389257, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada at Inspira, Home Health and Hospice Home health agency, Millville, NJ, CCN 317089
• Inspira Medical Center Vineland Hospital, Vineland, NJ, CCN 310032
• Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HHHIAD/Endpoint/HHHIAD

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.

• Complete Care of South Jersey

  • Nephrology Physician
  • Salem, NJ
  • NPI 1518320555
  Medicare reassignment Care Compare group NPD
• Tri State Nephrologists LLC

  • Nephrology Physician
  • Salem, NJ
  • NPI 1538514666
  Medicare reassignment NPD
• Careconnectmd New Jersey PC

  • General Practice Physician
  • Roseland, NJ
  • NPI 1417638990
  NPD
• Sultan Seretis Bussey Hospitalist LLC

  • Family Medicine Physician
  • Salem, NJ
  • NPI 1457792699
  NPD (past)

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

• Inspira Medical Centers, Inc.

  • General Acute Care Hospital
  • Vineland, NJ
  • NPI 1164487542
  Care Compare affiliation
• Inspira Medical Centers, Inc.

  • General Acute Care Hospital
  • Elmer, NJ
  • NPI 1255396024
  Care Compare affiliation
• Inspira Medical Centers, Inc.

  • General Acute Care Hospital
  • Mullica Hill, NJ
  • NPI 1366097032
  Care Compare affiliation
• South Jersey Hospital, Inc.

  • Physical Therapy Clinic/Center
  • Mullica Hill, NJ
  • NPI 1609158732

  Hospital

  Care Compare affiliation
• Tri-County Home and Hospice Care,LLC

  • Home Health Agency
  • West Deptford, NJ
  • NPI 1629431481
  Care Compare affiliation
• Tri-County Home and Hospice Care,LLC

  • Home Health Agency
  • Millville, NJ
  • NPI 1710340575
  Care Compare affiliation

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1073235578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 SHELMIRE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112726",
            "telephone_number": "856-392-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 SHELMIRE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112726",
            "telephone_number": "856-392-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "replacement_npi": "1073235578",
        "last_name": "THOMPSON-WHITE",
        "first_name": "SHANNAKAY",
        "middle_name": "JUDDIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR19666000",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN695502",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01374700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thompson Health Care Services LLC
• Tisa S Thompson-Bradley, IBCLC
• Iris Jeanette Thompson-Davis, B.A.
• Patrice Thompson-Dreuitt
• Peturah Ann Thompson-Harris, CRNA
• Alexa Thompson, OTR/L
• Alexandra Thompson, PA
• Alyssa Marie Thompson, LSW, CPRP
• Anna Thompson, MS
• Araina Thompson, LPN, AAHCA

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.