Active NPI
Joan Thompson, PA-C
- Physician Assistant
- Salt Lake City, UT
National Provider Identifier
1538244702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 7524958-1206
- Practice address
- 30 N 1900 E
RM 4B320 Som
Salt Lake City, UT 84132-2405 - Phone
- (801) 851-6390
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 003841 | NY | |
| Physician Assistant | 363A00000X | 7524958-1206 | UT | Primary |
Addresses
Primary practice location
30 N 1900 E
RM 4B320 Som
Salt Lake City, UT 84132-2405
Mailing address
30 N 1900 E
RM 4B320 Som
Salt Lake City, UT 84132-2405
Phone (801) 851-6390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01285029 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003841 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341964800000",
"number": "1538244702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 N 1900 E",
"address_2": "RM 4B320 SOM",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841322405",
"telephone_number": "801-851-6390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 N 1900 E",
"address_2": "RM 4B320 SOM",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841322405",
"telephone_number": "801-851-6390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "JOAN",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2012-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "003841",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "7524958-1206",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01285029",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.