Individual provider Active NPI

Bruce H Thompson, PHARMD, BCPS

  • Pharmacotherapy Pharmacist
  • Groton, CT
National Provider Identifier
1104801133
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
RPH4863 Issued in ND
Practice address
1 Wahoo Ave
Groton, CT 06349-2324
Phone
(860) 649-5700
Fax
(860) 649-2367
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X RPH4863 ND Primary

Addresses

Primary practice location

1 Wahoo Ave
Groton, CT 06349-2324

Mailing address

1 Wahoo Ave
Groton, CT 06349-2324
Phone (860) 694-2366

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH4863NDMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1104801133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WAHOO AVE",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063492324",
            "telephone_number": "860-694-2366",
            "fax_number": "860-694-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WAHOO AVE",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063492324",
            "telephone_number": "860-649-5700",
            "fax_number": "860-649-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "BRUCE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BCPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "ND",
            "license": "RPH4863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.