Individual provider Active NPI

Tracy L Thompson

  • Family Medicine Physician
  • Ada, OK
National Provider Identifier
1639162704
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OK3319 Issued in OK
Practice address
1921 Stonecipher Dr
Ada, OK 74820-3439
Phone
(580) 436-3980
Fax
(580) 421-6283
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OK3319 OK Primary

Addresses

Primary practice location

1921 Stonecipher Dr
Ada, OK 74820-3439

Mailing address

1925 Warrior Way
Ada, OK 74820-3491
Phone (580) 421-4570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040318001824 TX Practitioner - Family Practice 6305736604 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3319OKMDProfessional Counselor
OK3319OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Sep 24, 2020 Accepting new patients
Chickasaw Nation Division of Health CurrentSince Dec 7, 2023 Accepting new patients
Cherokee Nation Current Accepting new patients
Chickasaw Nation Division of Health CurrentSince Dec 7, 2023 Accepting new patients
United Indian Health Services, Inc. Past Accepting new patients
Cherokee Nation PastSince Mar 1, 2021 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center Past Accepting new patients
Northeastern State University College of Optometry Past Accepting new patients

Locations

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

1925 Warrior Way
Ada, OK 74820

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

395200 W 2900 Rd
Ochelata, OK 74051
Phone (918) 535-6000

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

821 Amohi Ln
Salina, OK 74365
Phone (918) 434-8500

301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400

471688 Highway 51
Stilwell, OK 74960

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/
  • Direct secure messaging: tthompson23793@direct.chickasawnationhealth.net

Organizations & group practices 12

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1639162704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 WARRIOR WAY",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203491",
            "telephone_number": "580-421-4570",
            "fax_number": "580-421-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER DR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-436-3980",
            "fax_number": "580-421-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TRACY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "OK3319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.