Evan Michael Thompson, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN295468 Issued in GA

Practice address

4069 Cherokee St NW Ste 400
Kennesaw, GA 30144-1278

Phone

(470) 766-1193

NPI assigned

Mar 13, 2024

Last updated

Jul 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Afc Physicians of Georgia PCGroup PAC ID 0345493375, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Afc Physicians of Georgia, PC

  • Urgent Care Clinic/Center
  • Chamblee, GA
  • NPI 1982950671
  Medicare reassignment Care Compare group NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment Care Compare group NPD
• Afc Physicians of Georgia Urgent Care, PC

  • Urgent Care Clinic/Center
  • Marietta, GA
  • NPI 1225617525
  Medicare reassignment NPD
• Afc Physicians of Georgia, PC

  • General Practice Physician
  • Columbus, GA
  • NPI 1982025318
  NPD

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1598523557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 SHALLOWFORD RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4069 CHEROKEE ST NW STE 400",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441278",
            "telephone_number": "470-766-1193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3481 Ernest W Barrett Pkwy SW",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300642703",
            "country_code": "US",
            "telephone_number": "678-384-5119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "EVAN",
        "middle_name": "MICHAEL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN295468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julian Thomas
• Phallon Thomas, RN
• Raven Ashley Thomas, MS, BCBA
• Melanie Rachel Thomason, DPT
• Connor Randall Thompson
• Jennifer Lynn Thompson, LPC
• Jordan Thompson, CAA
• Madalyn Thompson
• Tara Thompson, PHARMD.
• Tara Thompson, LMT,CD,CBE,CPD

• Family Nurse Practitioner in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.