Maryconnor Tacy Thompson, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

10025826 Issued in OR

Practice address

3825 Wolverine St NE
Salem, OR 97305-1201

Phone

(888) 875-7820

NPI assigned

Oct 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Planned Parenthood of the Columbia/Willamette, Inc.

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1053311860
  NPD (past)

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1083321285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 WOLVERINE ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051201",
            "telephone_number": "888-875-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 WOLVERINE ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051201",
            "telephone_number": "888-875-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MARYCONNOR",
        "middle_name": "TACY",
        "credential": "WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN287283",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "10025826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob John Thompson, RN
• Jeffery Allen Thompson
• Jesse Thompson, M.A.
• Katharyne Kerry Thompson
• Kevin H Thompson, DO
• Melissa Denise Thompson
• Sara Marie Thompson
• Sidney Thompson, PA-C
• Taylor Thompson, CHW
• Michelle Jean Thoreson, PT

• Women's Health Nurse Practitioner in Salem, OR
• Providers in Salem, OR by specialty
• Women's Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.