Individual provider Active NPI

Luke E Thompson, PHYSICAL THERAPIST

  • Physical Therapist
  • Jonesboro, AR
National Provider Identifier
1609935972
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT41762 Issued in CA
Practice address
2919 E Matthews Ave
Suite C
Jonesboro, AR 72401-4499
Phone
(870) 268-1400
Fax
(870) 268-1405
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT41762 CA Primary

Addresses

Primary practice location

2919 E Matthews Ave
Suite C
Jonesboro, AR 72401-4499

Mailing address

4402 Rebekah Dr
Olive Branch, MS 38654-9525
Phone (870) 530-7571

Other identifiers 1

IdentifierTypeStateIssuer
5W557OtherARBCBS PROVIDER NUMBER

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

State licenses

LicenseStateTypeSpecialty
PT41762CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Arkansas Orthopaedic and Sports Physical Therapy, Inc. Physical Therapist PastSince Sep 4, 2007 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1609935972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 REBEKAH DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386549525",
            "telephone_number": "870-530-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 E MATTHEWS AVE",
            "address_2": "SUITE C",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014499",
            "telephone_number": "870-268-1400",
            "fax_number": "870-268-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LUKE",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT41762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "5W557",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.