J Derek Thompson MD PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME51022 Issued in FL

Legal business name

J DEREK THOMPSON MD PA

Practice address

1210 Waterman Way
Tavares, FL 32778-5229

Phone

(352) 343-8284

Fax

(352) 343-8218

NPI assigned

Mar 18, 2008

Organization subpart

No

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

Authorized official

Name

J Derek Thompson, MD

Title

Owner

Phone

(352) 343-8284

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1326219387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785229",
            "telephone_number": "352-343-8284",
            "fax_number": "352-343-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785229",
            "telephone_number": "352-343-8284",
            "fax_number": "352-343-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J DEREK THOMPSON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-343-8284",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "FL",
            "license": "ME51022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Tavares, FL
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• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.