Individual provider Active NPI

Andrew Ryan Thompson, ABOC

  • Technician/Technologist
  • Omaha, NE
National Provider Identifier
1790929412
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Technician/TechnologistTaxonomy code 156F00000X
License
160458 Issued in NE
Practice address
4910 Dodge St Ste 107
Omaha, NE 68132
Phone
(402) 686-0908
Fax
(402) 596-5322
NPI assigned
Apr 24, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician/Technologist 156F00000X 160458 NE Primary

Addresses

Primary practice location

4910 Dodge St Ste 107
Omaha, NE 68132

Mailing address

4910 Dodge St Ste 107
Omaha, NE 68132
Phone (402) 686-0908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
160458NEMDTechnician/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fashion Forward Optical CurrentSince Dec 1, 2019 Accepting new patients

Locations

4910 Dodge St
Ste 107
Omaha, NE 68132
Phone (402) 686-0908

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1790929412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 DODGE ST STE 107",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68132",
            "telephone_number": "402-686-0908",
            "fax_number": "402-596-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 DODGE ST STE 107",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68132",
            "telephone_number": "402-686-0908",
            "fax_number": "402-596-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ANDREW",
        "middle_name": "RYAN",
        "credential": "ABOC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-24",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "NE",
            "license": "160458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.