Lisa Hicks Thompson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10001505A Issued in IN

Practice address

2700 Vissing Park Rd
Jeffersonville, IN 47130-5989

Phone

(812) 246-9809

Fax

(770) 573-9513

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• North Clark Medical Group LLC

  • General Practice Physician
  • Jeffersonville, IN
  • NPI 1376095711

  KY

  Medicare reassignment
• Zilmed LLC

  • Family Medicine Physician
  • Jeffersonville, IN
  • NPI 1083131957

  KY

  Medicare reassignment
• First Stop Urgent Care Madison PSC

  • Family Medicine Physician
  • Madison, IN
  • NPI 1538474580
  NPD (past)
• North Texas Inpatient and Geriatric Associates PA

  dba NTIGA Infusion

  • Home Infusion Therapy Pharmacy
  • Dallas, TX
  • NPI 1104020494
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1376631903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2476 CANTON RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300665377",
            "telephone_number": "812-246-9809",
            "fax_number": "770-573-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 VISSING PARK RD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305989",
            "telephone_number": "812-246-9809",
            "fax_number": "770-573-9513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402022407",
            "country_code": "US",
            "telephone_number": "812-246-9809",
            "fax_number": "770-573-9513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LISA",
        "middle_name": "HICKS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03855",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001505A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300011148",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190024301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190024302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190024303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therapy Works Inc
• Jenny Lin Theriault
• Michelle C Thistle, MA, CCC-SLP
• Jaydah Thomas
• Jennifer M. Thomas, RNFA
• Brooke Thornsberry, PA-C
• Eric Thornton, DMD
• Danielle Thurman, MSN, APRN, PMHNP-BC
• Olivia Tiller
• Len Timberlake, MSSW

• Physician Assistant in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.