Active NPI
Mark J Thompson, MD
- Family Medicine Physician
- Monroe, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 44379
- Practice address
- 515 22ND Ave
Monroe, WI 53566-1569 - Phone
- (608) 324-2566
- Fax
- (608) 324-1114
- NPI assigned
- Jul 7, 2006
- Last updated
- Jul 28, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 44379 | WI | Primary |
Addresses
Primary practice location
515 22ND Ave
Monroe, WI 53566-1569
Mailing address
515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34195300 | Medicaid | WI |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44379 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Care Medical Services | Past | Accepting new patients | |
| Innovis Health LLC | Family Medicine | Past | Accepting new patients |
| Dean Health Systems, Inc. | Past | Accepting new patients | |
| Dean Retail Services, Inc. | Past | Accepting new patients | |
| The Monroe Clinic, Inc. | Past | Accepting new patients |
Organizations & group practices 5
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.
-
dba SSM Health Davis Duehr Dean Eye Care - Portage
- Durable Medical Equipment & Medical Supplies
- Portage, WI
- NPI 1427085679
-
dba SSM Health Prescription Center
- Community/Retail Pharmacy
- Sun Prairie, WI
- NPI 1467562157
-
dba SSM Health Monroe Hospital
- General Acute Care Hospital
- Monroe, WI
- NPI 1740291491
-
dba Essentia Health Fosston Clinic
- Critical Access Hospital Clinic/Center
- Fosston, MN
- NPI 1073638565
-
dba Essentia Health-Osgood Clinic
- Multi-Specialty Clinic/Center
- Fargo, ND
- NPI 1144776576
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217203200000",
"number": "1558393801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 22ND AVE",
"city": "MONROE",
"state": "WI",
"postal_code": "535661569",
"telephone_number": "608-324-2566",
"fax_number": "608-324-1114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 22ND AVE",
"city": "MONROE",
"state": "WI",
"postal_code": "535661569",
"telephone_number": "608-324-2566",
"fax_number": "608-324-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "MARK",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2008-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "44379",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34195300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.