Active NPI
Jill Elizabeth Thompson, O.D.
- Optometrist
- Fort Thompson, SD
National Provider Identifier
1174705115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 648
- Practice address
- 1323 Bia Route 4
Fort Thompson, SD 57339-0704 - Phone
- (605) 245-1563
- Fax
- (605) 245-2384
- NPI assigned
- Nov 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 648 | SD | Primary |
Addresses
Primary practice location
1323 Bia Route 4
Fort Thompson, SD 57339-0704
Mailing address
1323 Bia Route 4
PO Box 200
Fort Thompson, SD 57339-0704
Phone (605) 245-1563
Other names 1
- Dr. Jill Elizabeth Faulstich
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1323 Bia RT Route 4
Fort Thompson, SD 57339-0200
Phone (605) 245-1500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 648 | SD | MD | Clinical Psychologist |
Organizations & group practices 1
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": "1196380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427760000000",
"number": "1174705115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1323 BIA ROUTE 4",
"address_2": "PO BOX 200",
"city": "FORT THOMPSON",
"state": "SD",
"postal_code": "573390704",
"telephone_number": "605-245-1563",
"fax_number": "605-245-2384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1323 BIA ROUTE 4",
"city": "FORT THOMPSON",
"state": "SD",
"postal_code": "573390704",
"telephone_number": "605-245-1563",
"fax_number": "605-245-2384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "JILL",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-30",
"last_updated": "2015-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SD",
"license": "648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JILL",
"last_name": "FAULSTICH",
"middle_name": "ELIZABETH",
"prefix": "DR.",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Thompson, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.