Lee Adam Thompson, PA-C
Individual provider Active NPI Physician Assistant · Woodlawn, VA
NPI 1104800978 · NPPES record last updated Aug 26, 2014
Key facts
- NPI
- 1104800978
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0110-001042 (VA)
- Practice address
- 5261 Carrollton Pike
Suite B
Woodlawn, VA 24381-3030 - Phone
- (276) 238-8876
- Fax
- (276) 238-8886
- NPI assigned
- Dec 5, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pai Participant 29 PC
Practice addresses (Care Compare)
211 Milton Brown Heirs Rd
Boone, NC 28607-8708
Phone (828) 264-6720
Hospital & facility affiliations
- Alleghany Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040109000482 | VA | Practitioner - Physician Assistant | 3678473428 | Reassigns benefits to 3 organizations |
| I20090625000591 | NC | Practitioner - Physician Assistant | 3678473428 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110-001042 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pai Participant 29, P.C. | Current |
Accepting new patients | |
| Eventus WH PLLC Care, LLC | Current |
Accepting new patients | |
| Carilion Healthcare Corporation | Past | Accepting new patients | |
| Mid-Atlantic Eldercare, PLLC | Past | Accepting new patients |
Locations
211 Milton Brown Heirs Rd
Boone, NC 28607
Phone (828) 264-6720
1287 Newsome St
Mount Airy, NC 27030
Phone (336) 786-2133
179 Combs St
Sparta, NC 28675
Phone (336) 372-2441
999 Waterside Dr
Ste 2525
Norfolk, VA 23510
Phone (757) 777-3787
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110-001042 | VA | Yes |
Addresses
Primary practice location
5261 Carrollton Pike
Suite B
Woodlawn, VA 24381-3030
Mailing address
5261 Carrollton Pike
Suite B
Woodlawn, VA 24381-3030
Phone (276) 238-8876
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8926140 | Medicaid | VA | |
| 8926158 | Medicaid | VA |
Other providers in Woodlawn, VA
- Jamie Wood Smith
- Southwest Podiatry, P.C.
- Vanessa Jean Sturgill Fant
- Charles Houston Teaters
- Terzetto Diagnostic Services
- Darlene Burcham Vaughn
- William Ward
- Charles W West
- Deborah Willis
- Dan Carlton Worrell
All providers in Woodlawn, VA · Physician Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.