Individual provider Active NPI

Bobby Thompson, PHARM.D

  • Pharmacist
  • Lake Charles, LA
National Provider Identifier
1457722399
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PST.020854 Issued in LA
Practice address
2000 Ryan St
Lake Charles, LA 70601-7314
Phone
(337) 439-4241
NPI assigned
Oct 19, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16616 AL
Pharmacist 183500000X P010911 MS
Pharmacist 183500000X PST.020854 LA Primary

Addresses

Primary practice location

2000 Ryan St
Lake Charles, LA 70601-7314

Mailing address

2845 Country Club Rd Apt 910
Lake Charles, LA 70605-6046
Phone (337) 439-4241

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
16616ALMDPharmacist
PST.020854LAMDPharmacist
P010911MSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1457722399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 COUNTRY CLUB RD APT 910",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706056046",
            "telephone_number": "337-439-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 RYAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017314",
            "telephone_number": "337-439-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "BOBBY",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-19",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "16616",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "P010911",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.020854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.