NPIMap

Individual provider Active NPI

Jacob Cecil Thompson, PA

  • Physician Assistant
  • Flint, MI
National Provider Identifier
1205210226
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007385 Issued in MI
Practice address
4466 W Bristol Rd
Flint, MI 48507-3170
Phone
(810) 733-1200
Fax
(810) 733-0688
NPI assigned
Jul 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007385 MI Primary

Addresses

Primary practice location

4466 W Bristol Rd
Flint, MI 48507-3170

Mailing address

4466 W Bristol Rd
Flint, MI 48507-3170
Phone (810) 733-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150828001692 MI Practitioner - Physician Assistant 7810203320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1225 S Latson Rd
Howell, MI 48843-7643

1400 Genesys Pkwy
B136
Grand Blanc, MI 48439-8068
Phone (810) 606-7629

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 424-3000

16001 W 9 Mile Rd 3Rd FL
Providence Hospital Gastrology
Southfield, MI 48075-4818
Phone (248) 849-6033

16001 W 9 Mile Rd 3Rd Floor
Providence Hospital Gastrology
Southfield, MI 48075-4818
Phone (248) 849-6033

26850 Providence Pkwy
Novi, MI 48374-1213
Phone (248) 347-2435

26850 Providence Pkwy
Suite 260
Novi, MI 48374-1256
Phone (248) 465-5140

47601 Grand River Ave
Novi, MI 48374-1233

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
68.79 of 100Reported as group
Quality
20.79
Promoting interoperability
94
Improvement activities
40
Cost
80.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital CurrentSince May 1, 2025 Accepting new patients
Henry Ford Health Providence Hospital CurrentSince May 1, 2025 Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients
Henry Ford Cornerstone Medical Group Past Accepting new patients
Advanced Orthopedic Specialists PC Past Accepting new patients

Locations

1400 Genesys Pkwy
#B136
Grand Blanc, MI 48439
Phone (810) 606-7629

1225 S Latson Rd
Ste 380
Howell, MI 48843
Phone (248) 465-5140

1225 S Latson Rd
Ste 130
Howell, MI 48843
Phone (517) 338-2360

26850 Providence Pkwy
Ste 260
Novi, MI 48374
Phone (248) 465-5140

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

16001 W 9 Mile Rd
Fl 5
Southfield, MI 48075
Phone (248) 380-4335

Interoperability endpoints

  • Direct secure messaging: jthompson1155621@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

Organizations & group practices 7

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 7

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": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1205210226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4466 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073170",
            "telephone_number": "810-733-1200",
            "fax_number": "810-733-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073170",
            "telephone_number": "810-733-1200",
            "fax_number": "810-733-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JACOB",
        "middle_name": "CECIL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.