Individual provider Active NPI

Courtney Jane Thompson, DNP, FNP

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1629487285
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001073 Issued in CA
Practice address
4168 Front St
San Diego, CA 92103-2030
Phone
(619) 543-3995
NPI assigned
Aug 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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 95001073 CA Primary

Addresses

Primary practice location

4168 Front St
San Diego, CA 92103-2030

Mailing address

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (619) 471-9224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150415000903 CA Practitioner - Nurse Practitioner 1658699046 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95001073CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince Sep 29, 2015 Accepting new patients
Regents of the University of California CurrentSince Sep 29, 2015 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 23, 2015 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 23, 2015 Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

4168 Front St
Fl 3
San Diego, CA 92103
Phone (619) 543-3995

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4168 Front St
San Diego, CA 92103
Phone (619) 471-0420

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 7

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": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1629487285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-471-9224",
            "fax_number": "619-543-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4168 FRONT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032030",
            "telephone_number": "619-543-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "COURTNEY",
        "middle_name": "JANE",
        "credential": "DNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.