Jeremy Thompson
Individual provider Active NPI Physician Assistant · Minot Afb, ND
NPI 1770936940 · NPPES record last updated Feb 2, 2023
Key facts
- NPI
- 1770936940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 10 Missile Ave
Minot Afb, ND 58705-5003 - Phone
- (701) 723-5190
- NPI assigned
- Jul 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
10 Missile Ave
Minot Afb, ND 58705-5003
Mailing address
10 Missile Ave
Minot Afb, ND 58705-5003
Phone (701) 723-5190
Other providers in Minot Afb, ND
- Elaine W. Sit
- Sarah Jane Slagle
- Ethan W Slater
- David Michael Smith
- David Allen Steele
- Shone L Topham
- Joshua James Turner
- Nykole Lynn Tupaz Turner
- Matthew Gregory Vizer
- David William Walsh
All providers in Minot Afb, ND · Physician Assistant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.