Individual provider Active NPI

Jeffrey D Thompson, MD

  • Specialist
  • Medford, OR
National Provider Identifier
1659356467
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD07147 Issued in OR
Practice address
18 Myrtle St
Suite 102
Medford, OR 97504-7471
Phone
(541) 779-2918
Fax
(541) 779-6149
NPI assigned
Dec 14, 2005
Last updated
Aug 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD07147 OR Primary

Addresses

Primary practice location

18 Myrtle St
Suite 102
Medford, OR 97504-7471

Mailing address

18 Myrtle St
Suite 102
Medford, OR 97504-7471
Phone (541) 779-2918

Other identifiers 1

IdentifierTypeStateIssuer
203216MedicaidOR

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 Medicine

State licenses

LicenseStateTypeSpecialty
MD07147ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas Mills MD LLC PastSince Jan 7, 2017 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1659356467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MYRTLE ST",
            "address_2": "SUITE 102",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047471",
            "telephone_number": "541-779-2918",
            "fax_number": "541-779-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 MYRTLE ST",
            "address_2": "SUITE 102",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047471",
            "telephone_number": "541-779-2918",
            "fax_number": "541-779-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD07147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203216",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.