Individual provider Active NPI

Venessa Joan Thompson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1801809702
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
107667 Issued in AZ
Practice address
11011 S 48TH St Ste 101
Phoenix, AZ 85044-1787
Phone
(602) 730-9670
Fax
(480) 864-9440
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 107667 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 107667 AZ Primary

Addresses

Primary practice location

11011 S 48TH St Ste 101
Phoenix, AZ 85044-1787

Mailing address

11011 S 48TH St Ste 101
Phoenix, AZ 85044-1787
Phone (602) 730-9670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606002709 AZ Practitioner - Nurse Practitioner 8426055419 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107667AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Canyon Psychiatry CurrentSince Sep 1, 2024 Accepting new patients
Boojum Obstetrics and Gynecology CurrentSince Jul 1, 2019 Accepting new patients
Valley Women for Women, PC PastSince Aug 15, 2013 Accepting new patients
Arizona OB GYN Affiliates PC Past Accepting new patients

Locations

3367 S Mercy Rd
Ste 207
Gilbert, AZ 85297
Phone (480) 855-5900

11011 S 48th St
Ste 101
Phoenix, AZ 85044
Phone (480) 893-0515

Organizations & group practices 4

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1801809702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 S 48TH ST STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850441787",
            "telephone_number": "602-730-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 S 48TH ST STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850441787",
            "telephone_number": "602-730-9670",
            "fax_number": "480-864-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "VENESSA",
        "middle_name": "JOAN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "107667",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "107667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.