Active NPI
Radhika N Thompson
- Pediatrics Physician
- St Louis Park, MN
National Provider Identifier
1205805793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 44368
- Practice address
- 6500 Excelsior Blvd
St Louis Park, MN 55426-4702 - Phone
- (952) 993-3123
- NPI assigned
- Mar 16, 2006
- Last updated
- Mar 7, 2012
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 44368 | MN | Primary |
Addresses
Primary practice location
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Mailing address
3800 Park Nicollet Blvd
Credentialing
St Louis Park, MN 55416-2527
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44368 | MN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Methodist Hospital | Past | Accepting new patients | |
| Park Nicollet Clinic | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1649220724
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331078400000",
"number": "1205805793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 PARK NICOLLET BLVD",
"address_2": "CREDENTIALING",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554162527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6500 EXCELSIOR BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554264702",
"telephone_number": "952-993-3123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "RADHIKA",
"middle_name": "N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-16",
"last_updated": "2012-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "44368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.