Kelsey M Thompson, D.D.S.
Individual provider Active NPI General Practice Dentistry · MC Gregor, TX
NPI 1194100016 · NPPES record last updated May 12, 2023
Key facts
- NPI
- 1194100016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 10127 (TN)
- Practice address
- 500 Johnson Dr
MC Gregor, TX 76657-1441 - Phone
- (254) 313-5200
- Fax
- (254) 313-5299
- NPI assigned
- Jul 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230601000648 | TX | Practitioner - Dentist | 1658676804 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10127 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heart of Texas Community Health Center Inc | Current | Accepting new patients | |
| Heart of Texas Community Health Center, Inc. | Current |
Accepting new patients | |
| Heart of Texas Community Health Center, Inc | Current |
Accepting new patients | |
| A. Roy Wrather, D.D.S. | General Practice | Past | Accepting new patients |
| Crown Medical Monitoring PC | Past |
Accepting new patients |
Locations
500 Johnson Dr
McGregor, TX 76657
Phone (254) 313-5200
1600 Providence Dr
Waco, TX 76707
Phone (254) 313-4200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10127 | TN | Yes |
Addresses
Primary practice location
500 Johnson Dr
MC Gregor, TX 76657-1441
Mailing address
2289 Norwalk St
Hamtramck, MI 48212-3416
Other providers in MC Gregor, TX
- Redi2Go
- Alvia Robles
- Shelly Leigh Rogers-Sharer
- John M Shultz
- Sarah Smith
- Kelsi Elizabeth Wade
- Lynette Wilson
- Jennifer N Zuri
All providers in MC Gregor, TX · General Practice Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.