Individual provider Active NPI

Nathan R Thompson, MD

  • Family Medicine Physician
  • Redmond, OR
National Provider Identifier
1124287321
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD150934 Issued in OR
Practice address
211 NW Larch Ave
Redmond, OR 97756-1357
Phone
(541) 548-2164
Fax
(541) 548-0534
NPI assigned
Jun 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60018029 WA
Family Medicine Physician 207Q00000X MD150934 OR Primary

Addresses

Primary practice location

211 NW Larch Ave
Redmond, OR 97756-1357

Mailing address

PO Box 1420
Redmond, OR 97756-0400
Phone (541) 548-2164

Other identifiers 2

IdentifierTypeStateIssuer
500620526MedicaidOR
11865892OtherORCAQH ID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nthompson17716@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100630000843 OR Practitioner - Family Practice 8022182658 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60018029WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Dec 31, 2024 Accepting new patients
St. Charles Health System, Inc. Current Accepting new patients
St. Charles Health System, Inc. CurrentSince Dec 31, 2024 Accepting new patients
Public Hospital District 1 of King County Past Accepting new patients
Bourget Health Services Inc Past Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

470 NE A St
Madras, OR 97741
Phone (541) 383-3668

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1124287321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1420",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560400",
            "telephone_number": "541-548-2164",
            "fax_number": "541-548-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NW LARCH AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561357",
            "telephone_number": "541-548-2164",
            "fax_number": "541-548-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "NATHAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60018029",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD150934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500620526",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11865892",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nthompson17716@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "211 NW Larch Ave",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977561357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.