Individual provider Active NPI

Deborah Lynne Thompson, FNP-BC

  • Family Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1619335205
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9369721 Issued in FL
Practice address
20423 State Road 7 Ste 28
Boca Raton, FL 33498-6797
Phone
(561) 617-4650
Fax
(351) 200-0476
NPI assigned
Feb 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9369721 FL Primary

Addresses

Primary practice location

20423 State Road 7 Ste 28
Boca Raton, FL 33498-6797

Mailing address

21516 Halstead Dr
Boca Raton, FL 33428-4843
Phone (630) 750-4317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160726000160 FL Practitioner - Nurse Practitioner 8527351774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20423 State Rd
7 Suite F10
Boca Raton, FL 33498-6774
Phone (630) 750-4317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9369721FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revolutionary Care Clinic LLC CurrentSince Feb 2, 2023 Accepting new patients

Locations

1690 S Congress Ave
Ste 205B
Delray Beach, FL 33445
Phone (561) 459-7300

Organizations & group practices 2

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": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1619335205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21516 HALSTEAD DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284843",
            "telephone_number": "630-750-4317",
            "fax_number": "351-200-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20423 STATE ROAD 7 STE 28",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334986797",
            "telephone_number": "561-617-4650",
            "fax_number": "351-200-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DEBORAH",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9369721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.