Active NPI
Debra Ann Gray Thomson, N.P.
- Acute Care Nurse Practitioner
- Winston Salem, NC
National Provider Identifier
1720069131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 130213
- Practice address
- Medical Center Blvd
10 Brenner Tower
Winston Salem, NC 27157-0001 - Phone
- (336) 713-2255
- Fax
- (336) 713-2242
- NPI assigned
- Nov 11, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 130213 | NC | Primary |
Addresses
Primary practice location
Medical Center Blvd
10 Brenner Tower
Winston Salem, NC 27157-0001
Mailing address
4207 Friedberg Church Rd
Clemmons, NC 27012-6875
Phone (336) 764-5444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7003643 | 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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300321 | NC | MD | Family Medicine Physician |
| 130213 | NC | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378425600000",
"number": "1720069131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4207 FRIEDBERG CHURCH RD",
"city": "CLEMMONS",
"state": "NC",
"postal_code": "270126875",
"telephone_number": "336-764-5444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"address_2": "10 BRENNER TOWER",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-713-2255",
"fax_number": "336-713-2242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMSON",
"first_name": "DEBRA",
"middle_name": "ANN GRAY",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-11",
"last_updated": "2013-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "NC",
"license": "130213",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7003643",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.