Individual provider Active NPI

Elisa Clupper Thompson, NP-C

  • Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1467791848
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
82995 Issued in OK
Practice address
750 NE 13TH St FL 3
Oklahoma City, OK 73104-5030
Phone
(405) 235-0040
Fax
(405) 235-4495
NPI assigned
Feb 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 82995 OK Primary

Addresses

Primary practice location

750 NE 13TH St FL 3
Oklahoma City, OK 73104-5030

Mailing address

750 NE 13TH St FL 3
Oklahoma City, OK 73104-5030
Phone (405) 235-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20130430000061 OK Practitioner - Nurse Practitioner 4082850565 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82995OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Allergy & Asthma Clinic CurrentSince Jul 10, 2017 Accepting new patients
Summit Medical Center Past Accepting new patients
QS Peds Med LLC PastSince Jun 26, 2022 Accepting new patients

Locations

3560 S Boulevard
Ste 150
Edmond, OK 73013

3560 S Boulevard
Edmond, OK 73013
Phone 4052350040315

3580 Rc Luttrell Dr
Ste 100
Norman, OK 73072
Phone 4052350040315

750 NE 13th St
Oklahoma City, OK 73104
Phone (405) 235-0040

750 NE 13th St
Fl 3
Oklahoma City, OK 73104
Phone (405) 235-0040

750 NE 13th St
Ste 300
Oklahoma City, OK 73104

1601 Health Center Pkwy
Ste 1200
Yukon, OK 73099
Phone 4052350040315

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71186
  • Direct secure messaging: elisa.thompson.1@29732.direct.athenahealth.com

Organizations & group practices 3

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": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467791848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 NE 13TH ST FL 3",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045030",
            "telephone_number": "405-235-0040",
            "fax_number": "405-235-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 NE 13TH ST FL 3",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045030",
            "telephone_number": "405-235-0040",
            "fax_number": "405-235-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ELISA",
        "middle_name": "CLUPPER",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "82995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.