Active NPI
Mary Jane Thompson, CNP
- Nurse Practitioner
- Conneaut, OH
National Provider Identifier
1790977205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1281636
- Practice address
- 530 Creek Rd
Conneaut, OH 44030-3018 - Phone
- (440) 813-5785
- NPI assigned
- Aug 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1281636 | OH | Primary |
Addresses
Primary practice location
530 Creek Rd
Conneaut, OH 44030-3018
Mailing address
6100 Rockside Woods Blvd N
Suite 425
Independence, OH 44131-2366
Phone (216) 643-2780
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)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1281636 | OH | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386633600000",
"number": "1790977205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6100 ROCKSIDE WOODS BLVD N",
"address_2": "SUITE 425",
"city": "INDEPENDENCE",
"state": "OH",
"postal_code": "441312366",
"telephone_number": "216-643-2780",
"fax_number": "216-524-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 CREEK RD",
"city": "CONNEAUT",
"state": "OH",
"postal_code": "440303018",
"telephone_number": "440-813-5785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "MARY",
"middle_name": "JANE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-17",
"last_updated": "2013-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "1281636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conneaut, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.