Active NPI
Shelly K Thompson
- Pediatrics Physician
- New Iberia, LA
National Provider Identifier
1811108566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 201197
- Practice address
- 2308 E Main St
Suite G
New Iberia, LA 70560-4041 - Phone
- (337) 367-2001
- Fax
- (337) 365-3050
- NPI assigned
- May 24, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 201197 | LA | Primary |
Addresses
Primary practice location
2308 E Main St
Suite G
New Iberia, LA 70560-4041
Mailing address
401 Youngsville Hwy
Suite 100
Lafayette, LA 70508-5173
Phone (337) 330-0031
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1214779 | Medicaid | LA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201197 | LA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Service District No. 1 of Iberia Parish | Past | Accepting new patients | |
| Pediatric Group of Acadiana, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- New Iberia, LA
- NPI 1285601088
-
- Specialist
- Lafayette, LA
- NPI 1265499628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473724800000",
"number": "1811108566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 YOUNGSVILLE HWY",
"address_2": "SUITE 100",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705085173",
"telephone_number": "337-330-0031",
"fax_number": "337-330-0059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2308 E MAIN ST",
"address_2": "SUITE G",
"city": "NEW IBERIA",
"state": "LA",
"postal_code": "705604041",
"telephone_number": "337-367-2001",
"fax_number": "337-365-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "SHELLY",
"middle_name": "K",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2016-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "201197",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1214779",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Iberia, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.