Nicole M Thompson

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00285400 Issued in NJ

Practice address

4 Eves Dr Ste A100
Marlton, NJ 08053-3126

Phone

(609) 267-9400

NPI assigned

Apr 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1669935169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 JUNIPER CIR",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282950",
            "telephone_number": "856-812-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 EVES DR STE A100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533126",
            "telephone_number": "609-267-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Mullica Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Glassboro",
            "state": "NJ",
            "postal_code": "080281700",
            "country_code": "US",
            "telephone_number": "856-256-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "NICOLE",
        "middle_name": "M",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00285400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.