Individual provider Active NPI

Susan F Thompson, WHCNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Austin, TX
National Provider Identifier
1407021884
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
MT1074892 Issued in TX
Practice address
12201 Renfert Way
#220
Austin, TX 78758-5354
Phone
(512) 425-3825
Fax
(512) 425-3829
NPI assigned
Apr 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X MT1074892 TX Primary

Addresses

Primary practice location

12201 Renfert Way
#220
Austin, TX 78758-5354

Mailing address

12201 Renfert Way
#220
Austin, TX 78758-5354
Phone (512) 425-3825

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
MT1074892TXMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1407021884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 RENFERT WAY",
            "address_2": "#220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585354",
            "telephone_number": "512-425-3825",
            "fax_number": "512-425-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 RENFERT WAY",
            "address_2": "#220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585354",
            "telephone_number": "512-425-3825",
            "fax_number": "512-425-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SUSAN",
        "middle_name": "F",
        "credential": "WHCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "TX",
            "license": "MT1074892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.