Individual provider Active NPI

Joel Wesley Thompson, PA-C

  • Medical Physician Assistant
  • Charlotte, NC
National Provider Identifier
1366429094
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
101018 Issued in NC
Practice address
6010 E WT Harris Blvd
Charlotte, NC 28215-4084
Phone
(704) 208-4134
Fax
(704) 248-7845
NPI assigned
Dec 23, 2005
Last updated
Apr 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 101018 NC Primary

Addresses

Primary practice location

6010 E WT Harris Blvd
Charlotte, NC 28215-4084

Mailing address

6010 E WT Harris Blvd
Charlotte, NC 28215-4084
Phone (704) 208-4134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040810001466 NC Practitioner - Physician Assistant 6901878834 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101018NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jemsek Clinic PA 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.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1366429094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 E WT HARRIS BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282154084",
            "telephone_number": "704-208-4134",
            "fax_number": "704-248-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 E WT HARRIS BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282154084",
            "telephone_number": "704-208-4134",
            "fax_number": "704-248-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JOEL",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.