Individual provider Active NPI

Davetta Regina Lewis Thompson, LPN

  • Licensed Practical Nurse
  • Cincinnati, OH
National Provider Identifier
1629415526
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN152905-M-IV Issued in OH
Practice address
821 S Fred Shuttlesworth Cir
Apt. 2
Cincinnati, OH 45229-2110
Phone
(513) 346-9640
NPI assigned
May 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN152905-M-IV OH Primary

Addresses

Primary practice location

821 S Fred Shuttlesworth Cir
Apt. 2
Cincinnati, OH 45229-2110

Mailing address

821 S Fred Shuttlesworth Cir
Apt. 2
Cincinnati, OH 45229-2110
Phone (513) 346-9640

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN152905-M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1629415526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 S FRED SHUTTLESWORTH CIR",
            "address_2": "APT. 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452292110",
            "telephone_number": "513-346-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 S FRED SHUTTLESWORTH CIR",
            "address_2": "APT. 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452292110",
            "telephone_number": "513-346-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS THOMPSON",
        "first_name": "DAVETTA",
        "middle_name": "REGINA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN152905-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.