Individual provider Active NPI

Phil Thompson, DO

  • Family Medicine Physician
  • Raleigh, MS
National Provider Identifier
1386705705
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10521 Issued in MS
Practice address
342 Magnolia Drive
Raleigh, MS 39153
Phone
(601) 782-9801
Fax
(601) 782-9955
NPI assigned
Dec 12, 2006
Last updated
Jun 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10521 MS Primary

Addresses

Primary practice location

342 Magnolia Drive
Raleigh, MS 39153

Mailing address

PO Box 10
Raleigh, MS 39153-0010
Phone (601) 782-9801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20150408001206 TN Order and Referring Only - Family PracticePractitioner - Family PracticePractitioner - Geriatric Medicine 0941372031

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1386705705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "RALEIGH",
            "state": "MS",
            "postal_code": "391530010",
            "telephone_number": "601-782-9801",
            "fax_number": "601-782-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 MAGNOLIA DRIVE",
            "city": "RALEIGH",
            "state": "MS",
            "postal_code": "39153",
            "telephone_number": "601-782-9801",
            "fax_number": "601-782-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "PHIL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, MS

Sources for this page

Verify at the official NPI Registry.