Individual provider Active NPI

Jordan Thompson

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1194177089
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202837 Issued in NC
Practice address
7845 Little Ave
Charlotte, NC 28226-8198
Phone
(704) 375-0100
NPI assigned
Jul 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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 202837 NC Primary
Nurse Practitioner 363L00000X 202837 NC

Addresses

Primary practice location

7845 Little Ave
Charlotte, NC 28226-8198

Mailing address

7845 Little Ave
Charlotte, NC 28226-8198
Phone (704) 375-0100

Other practice location 1

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 512-5363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20161213000819 NC Practitioner - Nurse Practitioner 3779863501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Lower Cape Fear Hospice IncorporatedGroup PAC ID 3375445190, 26 clinicians
Lifecare Supportive Medicine IncorporatedGroup PAC ID 5092284182, 20 clinicians

Practice addresses (Care Compare)

1414 Physicians Dr
Wilmington, NC 28401-7335
Phone (910) 796-7900

Hospital & facility affiliations

  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Cape Fear Hospice Incorporated CurrentSince Nov 4, 2019 Accepting new patients
Lower Cape Fear Hospice Incorporated CurrentSince Nov 4, 2019 Accepting new patients
Lower Cape Fear Hospice, Incorporated Current Accepting new patients

Locations

955 Mercy Ln
Bolivia, NC 28422
Phone (910) 754-5356

1414 Physicians Dr
Wilmington, NC 28401
Phone (910) 796-7900

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.

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": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1194177089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7845 LITTLE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268198",
            "telephone_number": "704-375-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7845 LITTLE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268198",
            "telephone_number": "704-375-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-512-5363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "202837",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "202837",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.