Active NPI
Joseph L Thompson III, M.D.
- Family Medicine Physician
- Clinton, TN
National Provider Identifier
1699762476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD0000017049
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q023729 | Medicaid | TN | |
| 70060 | Other | TN | BLUE CROSS |
| 080011135 | Other | TN | RAILROAD MEDICARE |
| 3021288 | Medicaid | TN |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New 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.
-
- Family Medicine Physician
- Knoxville, TN
- NPI 1457302010
-
- Multi-Specialty Clinic/Center
- Crossville, TN
- NPI 1053414698
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.