Individual provider Active NPI

Stephanie Elaine Thompson, FNP

  • Family Nurse Practitioner
  • Hickory Flat, MS
National Provider Identifier
1811150402
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R855906 Issued in MS
Practice address
250 Oak Street
Hickory Flat, MS 38633-0035
Phone
(662) 333-1128
Fax
(662) 333-1196
NPI assigned
Jul 3, 2008
Last updated
Dec 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R855906 MS Primary

Addresses

Primary practice location

250 Oak Street
Hickory Flat, MS 38633-0035

Mailing address

PO Box 35
Hickory Flat, MS 38633-0035
Phone (662) 333-1128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20101109000451 MS Practitioner - Nurse Practitioner 8123213709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

250 Oak St
Hickory Flat, MS 38633-0355
Phone (662) 333-1128

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R855906MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hernando Family Medical Clinic, LLC Family Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22832/brand/1/csg/1/fhir/r4
  • Direct secure messaging: stephanie.thompson.1@8477.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1811150402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35",
            "city": "HICKORY FLAT",
            "state": "MS",
            "postal_code": "386330035",
            "telephone_number": "662-333-1128",
            "fax_number": "662-333-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 OAK STREET",
            "city": "HICKORY FLAT",
            "state": "MS",
            "postal_code": "386330035",
            "telephone_number": "662-333-1128",
            "fax_number": "662-333-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "STEPHANIE",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R855906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory Flat, MS

Sources for this page

Verify at the official NPI Registry.