Tyler Bradshaw Thompson, IDC

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

34, Farenholt Ave
San Diego, CA 92134-0001

Phone

(619) 532-7962

NPI assigned

Jun 24, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1083275762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10061 RIO SAN DIEGO DR APT 302",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085659",
            "telephone_number": "740-424-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34, FARENHOLT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TYLER",
        "middle_name": "BRADSHAW",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MILITARY",
            "identifier": "59672019",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tyler.B.Thompson6.mil@mail.mil",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "34, Farenholt Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921340001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sophie Thompson
• Susan Denise Thompson, NP-C
• Taylor Rose Thompson
• Teresita Salve Thompson
• Tracey Lynn Thompson, RN
• Zoe Daelynn Thompson
• Clarita Delia Thoms, MA MFT
• Allison Claire Thomsen
• Christina Nicole Thomsen, HHP, LMT,
• Andrew Thomas Thomson

• Military Health Care Provider in San Diego, CA
• Providers in San Diego, CA by specialty
• Military Health Care Provider in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.