Individual provider Active NPI

Wyndi T Thompson, CRNP, DNP

  • Nurse Practitioner
  • Enterprise, AL
National Provider Identifier
1396926515
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-090101 Issued in AL
Practice address
101 Professional LN
Enterprise, AL 36330-2085
Phone
(334) 347-3404
Fax
(334) 393-0613
NPI assigned
Nov 15, 2007
Last updated
Nov 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-090101 AL Primary

Addresses

Primary practice location

101 Professional LN
Enterprise, AL 36330-2085

Mailing address

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 712-3314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080211000024 AL Practitioner - Nurse Practitioner 9436232725 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Medcore Associates, PLLC Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority CurrentSince Sep 1, 2015 Accepting new patients
Pathology Laboratory Associates Current Accepting new patients
Southeast Alabama Medical Center Employee Pharmacy Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1118 Ross Clark Cir
Ste 500
Dothan, AL 36301
Phone (334) 794-4159

1245 Westgate Pkwy
Dothan, AL 36303
Phone (334) 793-9595

252 Larkin Rd
Elba, AL 36323
Phone (334) 670-5427

101 Professional Ln
Enterprise, AL 36330
Phone (334) 347-3404

1376 Brickyard Rd
Chipley, FL 32428
Phone (850) 638-0552

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1396926515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-712-3314",
            "fax_number": "334-793-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL LN",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302085",
            "telephone_number": "334-347-3404",
            "fax_number": "334-393-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "WYNDI",
        "middle_name": "T",
        "credential": "CRNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-090101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.