Brenda J Thompson, MEDICAL DOCTOR

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

01028053 Issued in IN

Practice address

1021 W 5TH Ave
Gary, IN 46402-1703

Phone

(219) 880-1190

Fax

(219) 880-0784

NPI assigned

Jul 28, 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 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bthompson108846@direct.ochin.org

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.

• Community Healthnet Inc

  • Community Health Clinic/Center
  • Gary, IN
  • NPI 1952332298
  Medicare reassignment NPD
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1811650716
  NPD
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1164161469
  NPD (past)
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1649539933
  NPD (past)
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1891262762
  NPD (past)
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1952660243
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1386658250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W 5TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021703",
            "telephone_number": "219-880-1190",
            "fax_number": "219-880-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W 5TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021703",
            "telephone_number": "219-880-1190",
            "fax_number": "219-880-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "BRENDA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036047737",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IN",
            "license": "01028053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100167580A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chester Lee Thomas Jr.
• Christina Lee Thomas, MS
• La Donna Thomas, CADC, MISA I
• Lashai D Thomas
• Y-Gene Thompson-Rogers
• Rosie Lee Thompson, L.C.S.W.
• Carolyn Ann Thorpe, MSW, LCSW, LCAC
• Melzine Tillman
• Timilla'S Mentoring Center
• Shelley Leann Tinnel, RN

• Pediatric Adolescent Medicine Physician in Gary, IN
• Providers in Gary, IN by specialty
• Pediatric Adolescent Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.