Kimberly Lea Thompson-Tucker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

102890 Issued in NC

Practice address

1412 Carolina Ave
Washington, NC 27889-3314

Phone

(252) 623-2000

Fax

(877) 559-4667

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimberly L Thompson Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Brody School of Medicine at East Carolina University, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.09 of 100Reported as group

Quality

65.78

Improvement activities

40

Cost

76.37

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Fastmed P.C.

  • Family Medicine Physician
  • Durham, NC
  • NPI 1629841788
  Medicare reassignment Care Compare group
• Fastmed Primary Care, P.C.

  • Family Medicine Physician
  • Fayetteville, NC
  • NPI 1912774423
  NPD (past)
• Urgent Care Down East Inc

  • Urgent Care Clinic/Center
  • Washington, NC
  • NPI 1154721272
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1508985144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 CAROLINA AVE",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893314",
            "telephone_number": "252-623-2000",
            "fax_number": "877-559-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 CAROLINA AVE",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893314",
            "telephone_number": "252-623-2000",
            "fax_number": "877-559-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON-TUCKER",
        "first_name": "KIMBERLY",
        "middle_name": "LEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "102890",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "THOMPSON",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• The Mental Health Association in North Carolina, Inc
• The Mental Health Association in North Carolina, Inc.
• The Mental Health Association in North Carolina, Inc.
• The Oak
• The Senior Enrichment Center, LLC.
• Jacqueline Sue Thompson, MD
• Troy Hue Thompson Jr., RPH
• Thrivewell Health and Wellness PLLC
• Tideland Mental Health Center
• Tiffany Healthcare, Inc.

• Physician Assistant in Washington, NC
• Providers in Washington, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.