Active NPI
Roger Thompson
- Pharmacist
- Cleburne, TX
National Provider Identifier
1104161975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18916
- Practice address
- 1647 W Henderson St
Cleburne, TX 76033-4025 - Phone
- (817) 558-9994
- NPI assigned
- Dec 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18916 | TX | Primary |
Addresses
Primary practice location
1647 W Henderson St
Cleburne, TX 76033-4025
Mailing address
PO Box 1027
Burleson, TX 76097-1027
Phone (817) 480-3915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18916 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1104161975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1027",
"city": "BURLESON",
"state": "TX",
"postal_code": "760971027",
"telephone_number": "817-480-3915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1647 W HENDERSON ST",
"city": "CLEBURNE",
"state": "TX",
"postal_code": "760334025",
"telephone_number": "817-558-9994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "ROGER",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-05",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "18916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleburne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.