NPIMap

Individual provider Active NPI

Theodore Thompson, MD

  • Internal Medicine Physician
  • Bristol, TN
National Provider Identifier
1144224783
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD38948 Issued in TN
Practice address
1220 Volunteer Pkwy
Bristol, TN 37620-4628
Phone
(423) 274-6610
Fax
(423) 274-6619
NPI assigned
Jun 10, 2005
Last updated
Jun 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD38948 TN Primary
Internal Medicine Physician 207R00000X 0101055839 VA
Emergency Medicine Physician 207P00000X 38948 TN

Addresses

Primary practice location

1220 Volunteer Pkwy
Bristol, TN 37620-4628

Mailing address

105 W Stone Dr
Suite 6a
Kingsport, TN 37660-3365
Phone (423) 408-7220

Other identifiers 1

IdentifierTypeStateIssuer
3327207MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160202002303 SC Practitioner - Internal Medicine 1153397898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians of SC LLCGroup PAC ID 5890127344, 136 clinicians

Practice addresses (Care Compare)

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

3500 Hwy 17 Byp N
Mount Pleasant, SC 29466-9123
Phone (843) 724-2954

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD38948TNMDInternal Medicine Physician
38948TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Current Accepting new patients
24 On Physicians of SC, LLC CurrentSince Oct 1, 2019 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jan 21, 2016 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jan 21, 2016 Accepting new patients
Johnston Memorial Hospital, Inc Past Accepting new patients
Southwest Virginia Physicians for Women Past Accepting new patients
Roper St. Francis Mount Pleasant Hospital Past Accepting new patients
Norton Hma Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients

Locations

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1144224783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 VOLUNTEER PKWY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204628",
            "telephone_number": "423-274-6610",
            "fax_number": "423-274-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD38948",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101055839",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "38948",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3327207",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.