Active NPI
Willard Ray Thompson Jr., M.D.
- Otolaryngology Physician
- Salisbury, NC
National Provider Identifier
1659367449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 17741
- Practice address
- 530 Corporate Cir
Salisbury, NC 28147-8074 - Phone
- (704) 637-0158
- Fax
- (704) 637-7710
- NPI assigned
- Sep 27, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 17741 | NC | |
| Otolaryngology Physician | 207Y00000X | 17741 | NC | Primary |
Addresses
Primary practice location
530 Corporate Cir
Salisbury, NC 28147-8074
Mailing address
6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02606 | Other | NC | BCBS PROVIDER ID |
| 4412228 | Other | NC | AETNA |
| 30158896 | Other | SC | SELECT HEALTH OF SC |
| P01259200 | Other | NC | RAILROAD MEDICARE |
| Q17741 | Medicaid | SC | |
| 83198 | Other | NC | BCBSNC |
| 8902606 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17741 | NC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397692800000",
"number": "1659367449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 CORPORATE CIR",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281478074",
"telephone_number": "704-637-0158",
"fax_number": "704-637-7710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "WILLARD",
"middle_name": "RAY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2014-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "17741",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NC",
"license": "17741",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "02606",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4412228",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT HEALTH OF SC",
"identifier": "30158896",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01259200",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q17741",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "83198",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8902606",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.