Individual provider Active NPI

Justin John Thompson, D.O.

  • Emergency Medicine Physician
  • Idaho Falls, ID
National Provider Identifier
1346429552
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
O-0474 Issued in ID
Practice address
3100 Channing Way
Idaho Falls, ID 83404-7533
Phone
(208) 529-6269
NPI assigned
Oct 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X O-0474 ID Primary

Addresses

Primary practice location

3100 Channing Way
Idaho Falls, ID 83404-7533

Mailing address

3100 Channing Way
Idaho Falls, ID 83404-7533

Other practice location 1

450 E Main St
Rexburg, ID 83440-2048
Phone (208) 356-3691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080616000228 ID Practitioner - Emergency MedicinePractitioner - General Surgery 0446338339 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: General Surgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Integrated Care LLCGroup PAC ID 4284548116, 203 clinicians

Practice addresses (Care Compare)

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 529-6111

Hospital & facility affiliations

  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
  • Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Memorial Hospital CurrentSince Dec 1, 2018 Accepting new patients
Madison Co Memorial Hospital Current Accepting new patients
Intermountain Emergency Physicians Emergency Medicine CurrentSince Jul 1, 2008 Accepting new patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Jan 1, 2022 Accepting new patients
Mountain View Hospital LLC CurrentSince Jan 3, 2023 Accepting new patients
Riverwood Emergency Services Inc. Emergency Medicine Past Accepting new patients

Locations

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2327 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-1000

450 E Main St
Rexburg, ID 83440
Phone (208) 356-3691

Interoperability endpoints

  • Direct secure messaging: thompsju@direct.madisonmemorial.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d61ab3e4-55bb-4859-99e6-22c413b48f2a/

Organizations & group practices 6

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 2

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": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1346429552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-6269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 E Main St",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834402048",
            "country_code": "US",
            "telephone_number": "208-356-3691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JUSTIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-24",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-0474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.