Active NPI
Willie E. Thigpen, MD
- Family Medicine Physician
- San Diego, CA
National Provider Identifier
1093863052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C40766
- Practice address
- 4405 Vandever Ave
San Diego, CA 92120-3315 - Phone
- (619) 528-5000
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C40766 | CA | Primary |
Addresses
Primary practice location
4405 Vandever Ave
San Diego, CA 92120-3315
Mailing address
393 E Walnut St
3Rd Floor PHR Systems
Pasadena, CA 91188-0001
Phone (626) 405-3640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C407660 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Valley Indian Health, Inc | Family Medicine | Current | Accepting new patients |
| Central Valley Indian Health Inc | Family Medicine | Current | Accepting new patients |
| Central Valley Indian Health, Inc. | Family Medicine | Current | Accepting new patients |
| Pawhuska IHS Pharmacy | Past | Accepting new patients |
Locations
2740 Herndon Ave
Clovis, CA 93611
Phone (559) 299-2608
29369 Auberry Rd
Ste 102
Prather, CA 93651
Phone (559) 855-5390
Organizations & group practices 4
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.
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Pawhuska, OK
- NPI 1952303190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093863052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "393 E WALNUT ST",
"address_2": "3RD FLOOR PHR SYSTEMS",
"city": "PASADENA",
"state": "CA",
"postal_code": "911880001",
"telephone_number": "626-405-3640",
"fax_number": "626-405-6768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4405 VANDEVER AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921203315",
"telephone_number": "619-528-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIGPEN",
"first_name": "WILLIE",
"middle_name": "E.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "C40766",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C407660",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.