Carena May Thompson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

336.086682 Issued in IL

Practice address

111 Beaver Grade Road
Lapwai, ID 83540-0367

Phone

(208) 843-2842

Fax

(309) 527-3525

NPI assigned

May 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Carena M. Blacketer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1801833892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. DRAWER 367",
            "address_2": "NIMIIPUU HEALTH, 111 BEAVER GRADE ROAD",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "835400367",
            "telephone_number": "208-843-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BEAVER GRADE ROAD",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "835400367",
            "telephone_number": "208-843-2842",
            "fax_number": "309-527-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CARENA",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3676",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036123865",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "336.086682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS CONTROLLED SUBSTANCE #",
            "identifier": "336086682",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARENA",
            "last_name": "BLACKETER",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sally Ann Scheeval, LPN
• Edward D. Smith, M.D.
• Leslie R Smith, RN
• Sally Ann Springs
• Natasha Linn Stamper, PHARMD
• Timothy F Voglewede, M.S. MAC
• Thanh Danae Vu, MD
• Sabrina M Wakefield, LMSW
• Charlotte J Watters
• Kellee Denise Whipple, L.M.T.

• Family Medicine Physician in Lapwai, ID
• Providers in Lapwai, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.