Individual provider Active NPI

Pamela Thompson, DO

  • Family Medicine Physician
  • Holt, MI
National Provider Identifier
1740244169
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101009580 Issued in MI
Practice address
4221 Charlar Dr
Holt, MI 48842
Phone
(517) 694-7600
Fax
(517) 694-7003
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101009580 MI Primary

Addresses

Primary practice location

4221 Charlar Dr
Holt, MI 48842

Mailing address

4221 Charlar Dr
Holt, MI 48842
Phone (517) 694-7600

Other identifiers 2

IdentifierTypeStateIssuer
0853310394OtherMIBCBS
4570305MedicaidMI

Other names 1

  • Pamela Thompson Roberts Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000124 MI Practitioner - Family Practice 6204829864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4221 Charlar Dr
Holt, MI 48842-6804
Phone (517) 694-7600

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327
  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101009580MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pthompson15757@sparrowdirecthie.org

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1740244169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 CHARLAR DR",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "48842",
            "telephone_number": "517-694-7600",
            "fax_number": "517-694-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 CHARLAR DR",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "48842",
            "telephone_number": "517-694-7600",
            "fax_number": "517-694-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "PAMELA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101009580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0853310394",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4570305",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "ROBERTS",
            "middle_name": "THOMPSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Holt, MI

Sources for this page

Verify at the official NPI Registry.