Leif Thompson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4935 Issued in AK

Practice address

1408 19TH Ave
Fairbanks, AK 99701-5903

Phone

(907) 451-6682

Fax

(907) 459-3811

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: leif.thompson.1@15989.direct.athenahealth.com

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.

• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Manokotak, AK
  • NPI 1740340991
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1780667105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015926",
            "telephone_number": "907-451-6682",
            "fax_number": "907-459-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 19TH AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015903",
            "telephone_number": "907-451-6682",
            "fax_number": "907-459-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LEIF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "4935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014545",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelissa F Thomas, CDC1
• Timothy Thomas
• June M Thomasson, PA
• Diane R Thompson
• Kelsey Rae Thompson, PA-C
• Sean Carl Thompson
• Tamara Lu Thompson, LPN
• Emma Marina Thomsen
• Louis James Thornley, DDS
• Ruth Diane Thorum, LMSW

• Family Medicine Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.