Individual provider Active NPI

Jeanette Thompson, RN, MSN

  • Assisted Living Facility
  • Palm Bay, FL
National Provider Identifier
1730405234
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
13830 Issued in FL
Practice address
558 Rheine Rd NW
Palm Bay, FL 32907-1044
Phone
(321) 213-5531
NPI assigned
Apr 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9175115 FL
Diabetes Educator Registered Nurse 163WD0400X RN9175115 FL
Assisted Living Facility 310400000X 13830 FL Primary

Addresses

Primary practice location

558 Rheine Rd NW
Palm Bay, FL 32907-1044

Mailing address

558 Rheine Rd NW
Palm Bay, FL 32907-1044
Phone (321) 213-5531

Other practice location 1

480 Benton Dr
Melbourne, FL 32901-8687
Phone (321) 213-5531

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)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9175115FLMDRegistered Nurse
13830FLMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Loving Care Assisted Living Home Assisted Living Facility CurrentSince Jul 28, 2024 Accepting new patients

Organizations & group practices 1

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": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1730405234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 RHEINE RD NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071044",
            "telephone_number": "321-213-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 RHEINE RD NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071044",
            "telephone_number": "321-213-5531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Benton Dr",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329018687",
            "country_code": "US",
            "telephone_number": "321-213-5531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JEANETTE",
        "credential": "RN, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-09",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9175115",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "FL",
            "license": "RN9175115",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "13830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.