Kelli Yvonne Thompson

Primary specialty

Adult CompanionTaxonomy code 372600000X

License

1063186-1-FADS Issued in MN

Practice address

13 4TH Ave SE
Aitkin, MN 56431-1715

Phone

(218) 429-0140

NPI assigned

Apr 30, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Everlasting Memories

  • Adult Day Care Clinic/Center
  • Aitkin, MN
  • NPI 1982962718
  NPD (past) Authorized official

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1104184910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 4TH AVE SE",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "564311715",
            "telephone_number": "218-429-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 4TH AVE SE",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "564311715",
            "telephone_number": "218-429-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KELLI",
        "middle_name": "YVONNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "MN",
            "license": "1063186-1-FADS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Sue Struwve, MSW
• Arthur Charles Swanstrom, DDS
• David Douglas Taylor, MD
• Tori Telecky, OD
• Jeffery J Temple, NP
• Janelle Ap Trueblood, MD
• Cathleen Ann Twistol
• Jean E Twomey, L.AC.
• Ann Wedel, PT PHYSICAL THERAPIS
• William E. Stein, D.D.S.

• Adult Companion in Aitkin, MN
• Providers in Aitkin, MN by specialty
• Adult Companion in Minnesota

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

Verify at the official NPI Registry.