NPIMap

Individual provider Active NPI

Keith S Thompson, MD

  • Internal Medicine Physician
  • Greeley, CO
National Provider Identifier
1861470478
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32596 Issued in CO
Practice address
4800 W 25TH St
Greeley, CO 80634-3734
Phone
(970) 330-6400
Fax
(706) 270-0487
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32596 CO Primary

Addresses

Primary practice location

4800 W 25TH St
Greeley, CO 80634-3734

Mailing address

PO Box 2153 Dept 40339
Birmingham, AL 35287-9387
Phone (706) 271-0100

Other identifiers 2

IdentifierTypeStateIssuer
P00944807OtherCOMEDICARE RAILROAD CARRIER PTAN
01325968MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY, HI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090818000431 CO Practitioner - Internal Medicine 9830243302 Reassigns benefits to 1 organization
I20160915000663 WY Practitioner - Internal Medicine 9830243302 Reassigns benefits to 1 organization
I20210413001838 HI Practitioner - Internal Medicine 9830243302 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Care Physician Services LLCGroup PAC ID 5395861306, 18 clinicians

Practice addresses (Care Compare)

944 W Kawailani St
Hilo, HI 96720-3218
Phone (808) 959-9151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32596COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Jul 7, 2022 Accepting new patients
Life Care Physician Services, LLC Internal Medicine CurrentSince Sep 1, 2012 Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Jul 7, 2022 Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC Past Accepting new patients
Banner Greeley Specialists Past Accepting new patients

Locations

4800 W 25th St
Greeley, CO 80634
Phone (970) 330-6400

530 W 16th St
Salida, CO 81201
Phone (303) 751-2000

1333 Waianuenue Ave
Hilo, HI 96720
Phone (808) 896-5661

944 W Kawailani St
Hilo, HI 96720
Phone (808) 896-5661

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

4041 S Poplar St
Casper, WY 82601
Phone (307) 237-7444

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1861470478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153 DEPT 40339",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352879387",
            "telephone_number": "706-271-0100",
            "fax_number": "706-270-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 W 25TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343734",
            "telephone_number": "970-330-6400",
            "fax_number": "706-270-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KEITH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "32596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00944807",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01325968",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.