Individual provider Active NPI

Jeffery W Thompson, PHD

  • In Home Supportive Care Agency
  • Dayton, TN
National Provider Identifier
1366065575
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
L000000026358 Issued in TN
Practice address
215 Dayton Mountain Hwy
Dayton, TN 37321-1047
Phone
(423) 428-9291
Fax
(423) 428-9291
NPI assigned
May 21, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X
In Home Supportive Care Agency 253Z00000X L000000026358 TN Primary

Addresses

Primary practice location

215 Dayton Mountain Hwy
Dayton, TN 37321-1047

Mailing address

215 Dayton Mountain Hwy
Dayton, TN 37321-1047
Phone (423) 428-9291

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
L000000026358TNMDIn Home Supportive Care Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Home Care In Home Supportive Care PastSince Apr 1, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1366065575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 DAYTON MOUNTAIN HWY",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373211047",
            "telephone_number": "423-428-9291",
            "fax_number": "423-428-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 DAYTON MOUNTAIN HWY",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373211047",
            "telephone_number": "423-428-9291",
            "fax_number": "423-428-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JEFFERY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-21",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TN",
            "license": "L000000026358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.