Individual provider Active NPI

Stephanie Lagale Thompson, APRN

  • Pediatrics Physician
  • Blanchard, OK
National Provider Identifier
1396410973
Registry record updated Aug 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R0119766 Issued in OK
Practice address
3353 McDaniel
Blanchard, OK 73010-9705
Phone
(931) 217-8644
NPI assigned
Aug 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X R0119766 OK Primary

Addresses

Primary practice location

3353 McDaniel
Blanchard, OK 73010-9705

Mailing address

3353 McDaniel
Blanchard, OK 73010-9705
Phone (931) 217-8644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R0119766OKMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1628985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628985600000",
    "number": "1396410973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3353 MCDANIEL",
            "city": "BLANCHARD",
            "state": "OK",
            "postal_code": "730109705",
            "telephone_number": "931-217-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 MCDANIEL",
            "city": "BLANCHARD",
            "state": "OK",
            "postal_code": "730109705",
            "telephone_number": "931-217-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "STEPHANIE",
        "middle_name": "LAGALE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-15",
        "last_updated": "2021-08-15",
        "certification_date": "2021-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "R0119766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blanchard, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.