Mary Michelle Thompson, SPEECH THERAPIST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP006626 Issued in GA

Practice address

4116 Arkwright Rd
Suite 2
Macon, GA 31210-1707

Phone

(478) 477-0601

Fax

(973) 965-4580

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1629120969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 NORTHSIDE DR",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310693344",
            "telephone_number": "478-987-1610",
            "fax_number": "973-965-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4116 ARKWRIGHT RD",
            "address_2": "SUITE 2",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101707",
            "telephone_number": "478-477-0601",
            "fax_number": "973-965-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MARY",
        "middle_name": "MICHELLE",
        "credential": "SPEECH THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "487932448C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "487932448A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "487932448B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conroy Thompson
• Darrel W Thompson, RN 12088NP
• Joulia Mikhailovna Thompson, M.D.
• Kaitlyn Thompson, NP
• Kerri Thompson, LCSW
• Tracy Lynette Thompson
• William Thompson Jr., M.D.
• Avery Thomson, PA
• Josey Goldner Thoreson, OTR/L
• Ashby Perry Thornley, NP-C

• Speech-Language Pathologist in Macon, GA
• Providers in Macon, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.