Individual provider Active NPI

Adam J Thompson, PHD, ATC, LAT

  • Athletic Trainer
  • Marion, IN
National Provider Identifier
1417942889
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36000570A Issued in IN
Practice address
4201 S Washington St
Recreation & Wellness Center
Marion, IN 46953-4974
Phone
(765) 677-2335
Fax
(765) 677-2328
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36000570A IN Primary

Addresses

Primary practice location

4201 S Washington St
Recreation & Wellness Center
Marion, IN 46953-4974

Mailing address

4201 S Washington St
Recreation & Wellness Center
Marion, IN 46953-4974
Phone (765) 677-2335

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
36000570AINMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Wesleyan University Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417942889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 S WASHINGTON ST",
            "address_2": "RECREATION & WELLNESS CENTER",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469534974",
            "telephone_number": "765-677-2335",
            "fax_number": "765-677-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 S WASHINGTON ST",
            "address_2": "RECREATION & WELLNESS CENTER",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469534974",
            "telephone_number": "765-677-2335",
            "fax_number": "765-677-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ADAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36000570A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.