Individual provider Active NPI

Jess Lee Thompson III, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Oklahoma City, OK
National Provider Identifier
1376515452
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
44766 Issued in AZ
Practice address
1200 Childrens Ave
Ste 2E
Oklahoma City, OK 73104-4637
Phone
(405) 271-5789
Fax
(405) 271-1643
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 44766 AZ Primary
Surgery Physician 208600000X 31236 OK

Addresses

Primary practice location

1200 Childrens Ave
Ste 2E
Oklahoma City, OK 73104-4637

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (928) 759-5874

Other identifiers 1

IdentifierTypeStateIssuer
200528410AMedicaidOK

Other names 1

  • Jess Thompson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20110908002152 AZ Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 0547157125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
University of Southern California Keck School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

811 Ainsworth Dr
Suite 106
Prescott, AZ 86301-1687
Phone (928) 771-5256

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)21
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31236OKMDSurgery Physician
44766AZMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Jul 27, 2020 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Jul 27, 2020 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC Current Accepting new patients
Prescott Gastroenterology Past Accepting new patients
Banner-University Medical Group Past Accepting new patients
Ou Health Partners, Inc Past Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

1739 E Beverly Ave
Kingman, AZ 86409
Phone (602) 406-5483

811 Ainsworth Dr
Ste 106
Prescott, AZ 86301
Phone (928) 771-5252

1001 Willow Creek Rd
Ste 3200
Prescott, AZ 86301
Phone (928) 771-5595

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

811 Ainsworth Dr
Ste 109
Prescott, AZ 86301
Phone (928) 771-5595

3262 N Windsong Dr
Prescott Valley, AZ 86314
Phone (928) 759-5800

Organizations & group practices 7

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 1

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1376515452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "928-759-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE",
            "address_2": "STE 2E",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-5789",
            "fax_number": "405-271-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JESS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AZ",
            "license": "44766",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "31236",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200528410A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESS",
            "last_name": "THOMPSON",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.