Individual provider Active NPI

Ivy Elizabeth Thompson, FNP-BC

  • Nurse Practitioner
  • Milford, DE
National Provider Identifier
1164079828
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LG-0012661 Issued in DE
Practice address
800 N Dupont Blvd
Milford, DE 19963-1019
Phone
(302) 430-5705
Fax
(302) 430-5679
NPI assigned
Aug 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 104266 WV
Nurse Practitioner 363L00000X LG-0012661 DE Primary

Addresses

Primary practice location

800 N Dupont Blvd
Milford, DE 19963-1019

Mailing address

800 N Dupont Blvd
Milford, DE 19963-1019
Phone (302) 450-3481

Other practice location 1

26744 John J. Williams Hwy
Suite 3
Millsboro, DE 19966
Phone (302) 945-0440

Other identifiers 2

IdentifierTypeStateIssuer
1164079828MedicaidWV
250775533MedicaidDE

Other names 1

  • Mrs. Ivy Elizabeth Register Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191210001085 WV Practitioner - Nurse Practitioner 0345673166 Reassigns benefits to 1 organization
I20240515001880 DE Practitioner - Nurse Practitioner 0345673166 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0012661DEMDNurse Practitioner
104266WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valeo Medical, PLLC CurrentSince Dec 1, 2022 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Apr 14, 2025 Accepting new patients
Peninsula Health LLC CurrentSince Apr 17, 2024 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Apr 14, 2025 Accepting new patients

Locations

665 S Bay Rd
Unit C
Dover, DE 19901
Phone (302) 672-2319

800 N DuPont Blvd
Milford, DE 19963
Phone (302) 422-3000

26744 John J Williams Hwy
Unit 3
Millsboro, DE 19966
Phone (302) 945-0440

630 Fairmont Ave
Fairmont, WV 26554
Phone (304) 363-6662

260 Russell Ave
North Martinsvlle, WV 26155
Phone (304) 398-4949

1100 9th St
Ste E
Vienna, WV 26105

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1164079828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N DUPONT BLVD",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631019",
            "telephone_number": "302-450-3481",
            "fax_number": "302-430-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N DUPONT BLVD",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631019",
            "telephone_number": "302-430-5705",
            "fax_number": "302-430-5679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26744 John J. Williams Hwy",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Millsboro",
            "state": "DE",
            "postal_code": "19966",
            "country_code": "US",
            "telephone_number": "302-945-0440",
            "fax_number": "302-945-0442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "IVY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "104266",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0012661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164079828",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250775533",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IVY",
            "last_name": "REGISTER",
            "middle_name": "ELIZABETH",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.