NPIMap

Individual provider Active NPI

Kelli Michelle Thompson, APRN, FNP-C

  • Family Nurse Practitioner
  • Atlanta, TX
National Provider Identifier
1740807759
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1001204 Issued in TX
Practice address
1011 S William St
Atlanta, TX 75551-3245
Phone
(903) 796-2868
Fax
(903) 796-0826
NPI assigned
Jun 26, 2020
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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 1001204 TX Primary

Addresses

Primary practice location

1011 S William St
Atlanta, TX 75551-3245

Mailing address

PO Box 1326
Marshall, TX 75671-1326
Phone (903) 927-3782

Other identifiers 1

IdentifierTypeStateIssuer
1001204OtherTXTX BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200728003096 TX Practitioner - Nurse Practitioner 9436574126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Texas Border Health ClinicGroup PAC ID 8820038565, 55 clinicians

Practice addresses (Care Compare)

1011 S William St
Atlanta, TX 75551-3245
Phone (903) 796-2868

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Border Health Clinic CurrentSince Jun 29, 2020 Accepting new patients
East Texas Border Health Clinic Current Accepting new patients
East Texas Border Health Clinic CurrentSince Jun 29, 2020 Accepting new patients
East Texas Border Health Clinic PastSince Sep 21, 2025 Accepting new patients
East Texas Border Health Clinic PastSince Sep 5, 2021 Accepting new patients

Locations

1011 S William St
Atlanta, TX 75551
Phone (903) 796-2868

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

1400 College Dr
Texarkana, TX 75503
Phone (903) 791-1110

Organizations & group practices 6

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.

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": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1740807759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1326",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756711326",
            "telephone_number": "903-927-3782",
            "fax_number": "903-927-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 S WILLIAM ST",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "755513245",
            "telephone_number": "903-796-2868",
            "fax_number": "903-796-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KELLI",
        "middle_name": "MICHELLE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1001204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX BOARD OF NURSING",
            "identifier": "1001204",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, TX

Sources for this page

Verify at the official NPI Registry.