Individual provider Active NPI

Nicole Louise Thompson, NP

  • Nurse Practitioner
  • Athens, TX
National Provider Identifier
1669252276
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1137525 Issued in TX
Practice address
115 Medical Cir Ste 103
Athens, TX 75751-9004
Phone
(903) 677-8453
NPI assigned
Oct 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1137525 TX Primary

Addresses

Primary practice location

115 Medical Cir Ste 103
Athens, TX 75751-9004

Mailing address

115 Medical Cir Ste 103
Athens, TX 75751-9004
Phone (903) 677-8453

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231027002879 TX Practitioner - Nurse Practitioner 2769838606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1137525TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Oct 1, 2023 Accepting new patients
Etmc Physician Group Inc. CurrentSince Oct 1, 2023 Accepting new patients
Radiology Associates of North Texas PA Past Accepting new patients

Locations

115 Medical Cir
Ste 103
Athens, TX 75751
Phone (903) 677-8453

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

Interoperability endpoints

  • Direct secure messaging: nthompson350196@ahs.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1669252276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MEDICAL CIR STE 103",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519004",
            "telephone_number": "903-677-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MEDICAL CIR STE 103",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519004",
            "telephone_number": "903-677-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "NICOLE",
        "middle_name": "LOUISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1137525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TX

Sources for this page

Verify at the official NPI Registry.