Madeleine A Thompson, PA-C, RD, LD

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2108009745 Issued in MO

Practice address

621 S New Ballas Rd Ste 7008B
Saint Louis, MO 63141-8275

Phone

(314) 251-8750

NPI assigned

Apr 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Madeleine Harris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1417445941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 7008B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418275",
            "telephone_number": "314-251-8750",
            "fax_number": "314-251-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 7008B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418275",
            "telephone_number": "314-251-8750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15945 Clayton Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630112490",
            "country_code": "US",
            "telephone_number": "314-251-8750",
            "fax_number": "314-251-5571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MADELEINE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA-C, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2108009745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELEINE",
            "last_name": "HARRIS",
            "credential": "PA-C, RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keniesha Olga-May Thompson, M.D.
• Kimberly Thompson, LPC
• Latoya Thompson
• Laura R Thompson, MD
• Lisa Thompson
• Madisyn Thompson, PHARM.D.
• Margaret C Thompson, MD
• Mary Amanda Thompson, CDA
• Matthew Scott Thompson, MD
• Meridith Thompson, OTR

• Surgical Physician Assistant in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Surgical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.