Individual provider Active NPI

Elizabeth Eddins Thompson, ARNP

  • Family Nurse Practitioner
  • Williston, FL
National Provider Identifier
1720313950
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9251565 Issued in FL
Practice address
630 N Main St
Williston, FL 32696-1705
Phone
(352) 528-0587
Fax
(352) 528-4834
NPI assigned
Oct 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9251565 FL Primary

Addresses

Primary practice location

630 N Main St
Williston, FL 32696-1705

Mailing address

911 S Main St
Trenton, FL 32693-3239
Phone (352) 463-2374

Other identifiers 3

IdentifierTypeStateIssuer
ARNP9251565OtherFLSTATE LICENSE
62987OtherFLBCBSFL
001487600MedicaidFL

Other names 1

  • Elizabeth Astrid Eddins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20091215000261 FL Practitioner - Nurse Practitioner 4183764632 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Haile Medical Group PA CurrentSince Jan 3, 2012 Accepting new patients
Atlas Diagnostics Inc Past Accepting new patients

Locations

4750 SW 91st Dr
#A
Gainesville, FL 32608
Phone (352) 367-9602

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1720313950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 S MAIN ST",
            "city": "TRENTON",
            "state": "FL",
            "postal_code": "326933239",
            "telephone_number": "352-463-2374",
            "fax_number": "352-463-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N MAIN ST",
            "city": "WILLISTON",
            "state": "FL",
            "postal_code": "326961705",
            "telephone_number": "352-528-0587",
            "fax_number": "352-528-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ELIZABETH",
        "middle_name": "EDDINS",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-06",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9251565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ARNP9251565",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "62987",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001487600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "EDDINS",
            "middle_name": "ASTRID",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williston, FL

Sources for this page

Verify at the official NPI Registry.