Individual provider Active NPI

Brenda M. Thompson, FNP

  • Nurse Practitioner
  • Baxley, GA
National Provider Identifier
1487660353
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN070005 Issued in GA
Practice address
755 S Main St
Baxley, GA 31513-0130
Phone
(912) 705-2273
Fax
(912) 705-2274
NPI assigned
Jul 31, 2006
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN070005 GA Primary
Family Nurse Practitioner 363LF0000X RN070005 GA

Addresses

Primary practice location

755 S Main St
Baxley, GA 31513-0130

Mailing address

821 S Main St Ste a
Baxley, GA 31513-0163
Phone (912) 705-5483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20051026000223 GA Practitioner - Nurse Practitioner 4981621356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadows Multispecialty Associates LLCGroup PAC ID 6002223484, 28 clinicians

Practice addresses (Care Compare)

110 R T Stanley Sr Place
Lyons, GA 30436-5623
Phone (912) 526-9355

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
76.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN070005GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthie Community Center LLC Family CurrentSince Jun 1, 2021 Accepting new patients
Porter Medical Clinic,P.C. Current Accepting new patients
Meadows Multispecialty Associates, LLC CurrentSince May 23, 2022 Accepting new patients
Southeast Medical Group, P.C. Past Accepting new patients
South Georgia Internal Medicine,PC PastSince Apr 1, 2004 Accepting new patients
Adventist Health System Georgia Inc Past Accepting new patients

Locations

755 S Main St
Baxley, GA 31513
Phone (912) 367-4614

821 S Main St
Ste A
Baxley, GA 31513
Phone (912) 705-2273

1003 North Way
Darien, GA 31305
Phone (912) 437-4511

110 Rt Stanley SR Pl
Lyons, GA 30436
Phone (912) 526-9355

1707 Meadows Ln
Ste A
Vidalia, GA 30474
Phone (912) 538-0003

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: brenda.thompson@emc.gadirect.net
  • Direct secure messaging: brenda.thompson@hca5.eclinicaldirectplus.com
  • Direct secure messaging: brendathompson@fgeofferyc.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/8824/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1487660353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 S MAIN ST STE A",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130163",
            "telephone_number": "912-705-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S MAIN ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130130",
            "telephone_number": "912-705-2273",
            "fax_number": "912-705-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "BRENDA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN070005",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN070005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxley, GA

Sources for this page

Verify at the official NPI Registry.