Individual provider Active NPI

Jason Ambrose Thompson, D.C.

  • Chiropractor
  • Grayslake, IL
National Provider Identifier
1366741902
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011885 Issued in IL
Practice address
15 Commerce Dr Ste 108
Grayslake, IL 60030-7807
Phone
(847) 223-3158
Fax
(888) 481-4758
NPI assigned
Mar 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.011885 IL Primary

Addresses

Primary practice location

15 Commerce Dr Ste 108
Grayslake, IL 60030-7807

Mailing address

425 N Liberty St
Elgin, IL 60120-4268
Phone (847) 223-3158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120121000117 IL Practitioner - Chiropractic 2567639198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2295 Valley Creek Dr
Suite a
Elgin, IL 60123-2694
Phone (847) 742-5070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011885ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Adjusted Health LTD Chiropractor CurrentSince Sep 22, 2014 Accepting new patients
Lake County Physical Medicine, S.C. Past Accepting new patients
Atkinson Chiropractic and Acupuncture SC Chiropractor Past Accepting new patients

Locations

425 N Liberty St
Elgin, IL 60120
Phone (708) 742-5070

Organizations & group practices 3

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1366741902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N LIBERTY ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601204268",
            "telephone_number": "847-223-3158",
            "fax_number": "888-481-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 COMMERCE DR STE 108",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307807",
            "telephone_number": "847-223-3158",
            "fax_number": "888-481-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JASON",
        "middle_name": "AMBROSE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.