Active NPI
Susan N Thompson, M.D.
- Family Medicine Physician
- Great Barrington, MA
National Provider Identifier
1104824804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 54979
- Practice address
- 63 State Rd
Great Barrington, MA 01230-1223 - Phone
- (413) 644-9933
- Fax
- (413) 644-9433
- NPI assigned
- Jul 7, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 54979 | MA | Primary |
Addresses
Primary practice location
63 State Rd
Great Barrington, MA 01230-1223
Mailing address
63 State Rd
Great Barrington, MA 01230-1223
Phone (413) 644-9933
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104824804 | Other | HEALTH NEW ENGLAND | |
| 1104824804 | Other | CIGNA | |
| 1104824804 | Other | TUFTS | |
| 1104824804 | Other | UNITED HEALTH CARE PLAN SPECIFIC | |
| 1104824804 | Other | AETNA | |
| 1104824804 | Other | MA | BOSTON MEDICAL HEALTH PLAN |
| 1104824804 | Other | CDPHP | |
| 1104824804 | Other | FALLON | |
| 1104824804 | Other | MVP | |
| 1104824804 | Other | RAILROAD MEDICARE | |
| 1104824804 | Other | MA | BC/BS MA - BLUE CARD PPO |
| 11004271A | Medicaid | MA | |
| 1104824804 | Other | HARVARD PILGRM HEALTH CARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- susan.thompson.1@13063.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Great Barrington, MA
- NPI 1841364403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353888000000",
"number": "1104824804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 STATE RD",
"city": "GREAT BARRINGTON",
"state": "MA",
"postal_code": "012301223",
"telephone_number": "413-644-9933",
"fax_number": "413-644-9433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 STATE RD",
"city": "GREAT BARRINGTON",
"state": "MA",
"postal_code": "012301223",
"telephone_number": "413-644-9933",
"fax_number": "413-644-9433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "SUSAN",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2012-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "54979",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NEW ENGLAND",
"identifier": "1104824804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1104824804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "1104824804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE PLAN SPECIFIC",
"identifier": "1104824804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1104824804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOSTON MEDICAL HEALTH PLAN",
"identifier": "1104824804",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "1104824804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "1104824804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "1104824804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "1104824804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS MA - BLUE CARD PPO",
"identifier": "1104824804",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11004271A",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRM HEALTH CARE",
"identifier": "1104824804",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Great Barrington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.