Individual provider Active NPI

Gerald Kevin Thompson, ARNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1487096780
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9444970 Issued in FL
Practice address
1940 Harrison Ave
Panama City, FL 32405-4542
Phone
(850) 763-0017
Fax
(850) 532-6454
NPI assigned
Jul 27, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN124311 GA
Rehabilitation Registered Nurse 163WR0400X RN124311 GA
Registered Nurse 163W00000X RN124311 GA
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X RN124311 GA
General Practice Registered Nurse 163WG0000X RN124311 GA
Home Health Registered Nurse 163WH0200X RN124311 GA
Wound Care Registered Nurse 163WW0000X RN124311 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9444970 FL Primary

Addresses

Primary practice location

1940 Harrison Ave
Panama City, FL 32405-4542

Mailing address

1940 Harrison Ave
Panama City, FL 32405-4542
Phone (850) 763-0017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180507000779 FL Practitioner - Nurse Practitioner 0446514095 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN124311GAMDAddiction (Substance Use Disorder) Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Windmoor Healthcare Inc CurrentSince Nov 12, 2018 Accepting new patients

Locations

11300 US Highway 19 N
Clearwater, FL 33764
Phone (727) 541-2646

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": "1374883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1487096780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-763-0017",
            "fax_number": "850-532-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-763-0017",
            "fax_number": "850-532-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "GERALD",
        "middle_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "ARNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-27",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN124311",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "GA",
            "license": "RN124311",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN124311",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "RN124311",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "GA",
            "license": "RN124311",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "RN124311",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "GA",
            "license": "RN124311",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9444970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.