Active NPI
David Thompson, DO
- Emergency Medicine Physician
- Rockford, IL
National Provider Identifier
1659349850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036-070525
- Practice address
- 2400 N Rockton Ave
Rockford, IL 61103-3655 - Phone
- (815) 971-5000
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036-070525 | IL | Primary |
Addresses
Primary practice location
2400 N Rockton Ave
Rockford, IL 61103-3655
Mailing address
2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036070525 | Medicaid | IL |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-070525 | IL | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259107200000",
"number": "1659349850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 N ROCKTON AVE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611033655",
"telephone_number": "815-971-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 N ROCKTON AVE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611033655",
"telephone_number": "815-971-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "DAVID",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2009-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036-070525",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036070525",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.