Keara Susanna Thompson, NP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

4704348717 Issued in MI

Practice address

926 N Michigan Ave
Saginaw, MI 48602-4369

Phone

(989) 753-8453

Fax

(989) 755-9983

NPI assigned

Mar 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Keara Susanna Wilson Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20451/brand/1/csg/1/fhir/r4

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.

• Valley OB GYN Clinic PC

  • Specialist
  • Saginaw, MI
  • NPI 1891803904
  Medicare reassignment NPD
• Womens OB GYN PC

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1023096724
  Medicare reassignment NPD

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1134714009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 N MICHIGAN AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024369",
            "telephone_number": "989-753-8453",
            "fax_number": "989-755-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 N MICHIGAN AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024369",
            "telephone_number": "989-753-8453",
            "fax_number": "989-755-9983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Mackinaw Rd Ste 6100",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486049278",
            "country_code": "US",
            "telephone_number": "989-792-3100",
            "fax_number": "989-792-9860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KEARA",
        "middle_name": "SUSANNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MI",
            "license": "4704348717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEARA",
            "last_name": "WILSON",
            "middle_name": "SUSANNA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bill Andrae Thompson, KINESIOTHERAPIST
• Corie Astrom Thompson
• Devan Marie Thompson
• Jennifer Thompson
• Jessica Thompson
• Marc Evan Thompson, PA-C
• Robert F Thompson
• Santidra Thompson
• Shera Carolyn Ivy Thompson, FNP-BC
• Tracy Leigh Thompson, FNP-BC

• Obstetrics & Gynecology Nurse Practitioner in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Obstetrics & Gynecology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.