Jeremiah Thompson

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1622 4TH St
Santa Rosa, CA 95404-4020

Phone

(707) 583-9777

NPI assigned

Aug 27, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jeremy Thompson Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Kendall Individual Family and Marriage Therapists Inc

  • Marriage & Family Therapist
  • Santa Rosa, CA
  • NPI 1740830389
  Medicare reassignment NPD

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1831866615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044020",
            "telephone_number": "707-583-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JEREMIAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEREMY",
            "last_name": "THOMPSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Angela Thompson
• Christen Mikiko Thompson, A.R.N.P.
• Collin Thompson
• Corrine Jean Thompson
• Dean A. Thompson, MD
• Sara M Thompson
• Tara Thompson, OTD
• Vai Kahealani Thompson
• Helen Louise Thomson, MFT
• Marc Thorne, PA-C

• Student in an Organized Health Care Education/Training Program in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.