Individual provider Active NPI

Joseph L Thompson III, M.D.

  • Family Medicine Physician
  • Clinton, TN
National Provider Identifier
1699762476
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD0000017049 Issued in TN
Practice address
110 Executive Park Dr
Clinton, TN 37716-6876
Phone
(865) 494-9241
Fax
(865) 494-2522
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD0000017049 TN Primary

Addresses

Primary practice location

110 Executive Park Dr
Clinton, TN 37716-6876

Mailing address

110 Executive Park Dr
Clinton, TN 37716-6876
Phone (865) 494-9241

Other identifiers 4

IdentifierTypeStateIssuer
Q023729MedicaidTN
70060OtherTNBLUE CROSS
080011135OtherTNRAILROAD MEDICARE
3021288MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100824000629 TN Practitioner - Family Practice 2264556513 Practice locations: Clinton, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Family Medicine Past Accepting new patients
Crossville Medical Group PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1699762476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EXECUTIVE PARK DR",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166876",
            "telephone_number": "865-494-9241",
            "fax_number": "865-494-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EXECUTIVE PARK DR",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166876",
            "telephone_number": "865-494-9241",
            "fax_number": "865-494-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000017049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q023729",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "70060",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080011135",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3021288",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, TN

Sources for this page

Verify at the official NPI Registry.