NPIMap

Individual provider Active NPI

Charles Allen Thompson, M.D.

  • Interventional Cardiology Physician
  • Zachary, LA
National Provider Identifier
1528260072
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
10749R Issued in LA
Practice address
6550 Main Street
Suite 1000
Zachary, LA 70791-4079
Phone
(225) 654-1559
Fax
(225) 654-6212
NPI assigned
Jun 5, 2007
Last updated
Oct 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 10749R LA
Interventional Cardiology Physician 207RI0011X 10749R LA Primary

Addresses

Primary practice location

6550 Main Street
Suite 1000
Zachary, LA 70791-4079

Mailing address

PO Box 4176
Houma, LA 70361-4176
Phone (985) 876-0300

Other identifiers 2

IdentifierTypeStateIssuer
1666840MedicaidLA
P00398472OtherLARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040113000206 LA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 7315847597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Louisiana State University School of Medicine in New Orleans, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians

Practice addresses (Care Compare)

4801 McHugh Dr
Suite C Lane Dermatology
Zachary, LA 70791-4037
Phone (225) 658-4065

6300 Main St
Zachary, LA 70791-4037
Phone (225) 570-2618

6550 Main St
Suite 1000
Zachary, LA 70791-4092
Phone (225) 654-1559

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10
Varicose vein removal1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10749RLAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Service District 1 of East Baton Rouge Parish Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1528260072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4176",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703614176",
            "telephone_number": "985-876-0300",
            "fax_number": "985-872-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 MAIN STREET",
            "address_2": "SUITE 1000",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914079",
            "telephone_number": "225-654-1559",
            "fax_number": "225-654-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "10749R",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "10749R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1666840",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00398472",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

Verify at the official NPI Registry.