Individual provider Active NPI

Charlette Thompson

  • Family Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1467914655
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3012815 Issued in KY
Practice address
296 Meadow Valley Rd
Lexington, KY 40511-8788
Phone
(859) 492-9864
NPI assigned
Apr 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 3012815 KY
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 3012815 KY Primary

Addresses

Primary practice location

296 Meadow Valley Rd
Lexington, KY 40511-8788

Mailing address

296 Meadow Valley Rd
Lexington, KY 40511-8788
Phone (859) 492-9864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20231023001876 KY Practitioner - Nurse Practitioner 9537515812 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3012815KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC Multi-Specialty CurrentSince Apr 17, 2024 Accepting new patients
Healing Well Integrative Community Healthcare Services LLC Multi-Specialty CurrentSince Sep 4, 2023 Accepting new patients

Locations

1426 N Forbes Rd
Lexington, KY 40511
Phone (859) 492-9864

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1467914655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 MEADOW VALLEY RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405118788",
            "telephone_number": "859-492-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 MEADOW VALLEY RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405118788",
            "telephone_number": "859-492-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CHARLETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3012815",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.