Individual provider Active NPI

Stanley Craig Thompson, MD

  • Emergency Medicine Physician
  • Southaven, MS
National Provider Identifier
1740221365
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31479 Issued in TN
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(662) 349-4000
NPI assigned
Jun 8, 2006
Last updated
Dec 3, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 31479 TN Primary

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

PO Box 634706
Cincinnati, OH 45263-0001

Other identifiers 3

IdentifierTypeStateIssuer
3828889MedicaidTN
00122616MedicaidMS
3159921OtherTNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN, AR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040526001079 MS Practitioner - Emergency Medicine 8527049485 Reassigns benefits to 1 organization
I20070209000616 TN Practitioner - Emergency Medicine 8527049485 Reassigns benefits to 3 organizations
I20140410001022 AR Practitioner - Emergency Medicine 8527049485 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31479TNMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jan 1, 2005 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince May 1, 2012 Accepting new patients
Hospital Medicine Services of Tennessee PC CurrentSince Sep 1, 2016 Accepting new patients
Virtualcare Medical Services of Ny PC CurrentSince May 1, 2022 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1740221365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634706",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "662-349-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "STANLEY",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "31479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3828889",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122616",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3159921",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.