Deandra Marissah Thompson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

303 NW 11TH St
Fairfield, IL 62837-1206

Phone

(618) 842-2611

NPI assigned

Mar 11, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairfield Memorial Hospital AssociationGroup PAC ID 5698671741, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairfield Memorial Hospital 1 Hospital, Fairfield, IL, CCN 141311

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dthompson@direct.horizonhealthcare.nextgenshare.com

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.

• Fairfield Memorial Hospital Association

  • Family Medicine Physician
  • Fairfield, IL
  • NPI 1649442419
  Medicare reassignment Care Compare group NPD
• Fairfield Memorial Hospital Association

  • Critical Access Hospital
  • Fairfield, IL
  • NPI 1255422416
  NPD

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

• Fairfield Memorial Hospital Association

  • Critical Access Hospital
  • Fairfield, IL
  • NPI 1255422416
  Care Compare affiliation

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1134877939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 W 12TH ST",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "628391066",
            "telephone_number": "618-508-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 NW 11TH ST",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628371206",
            "telephone_number": "618-842-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DEANDRA",
        "middle_name": "MARISSAH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilbert Tennyson, BSW
• Kimberly Gaye Tennyson, M.ED.
• The Heart Group
• The Medicine Shoppe
• Emily S Thomann, DPT
• Wesley D Thompson, M.D.
• Janie Tibbs
• Total Renal Care Inc
• Mikayla Troyer
• Sarah R Turner

• Physician Assistant in Fairfield, IL
• Providers in Fairfield, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.