Individual provider Active NPI

Michael S Thompson, D.O.

  • Anesthesiology Physician
  • Roanoke, VA
National Provider Identifier
1881648707
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0102204773 Issued in VA
Practice address
5115 Bernard Dr Ste 201
Roanoke, VA 24018-4367
Phone
(540) 345-0289
Fax
(540) 345-9569
NPI assigned
May 22, 2006
Last updated
Mar 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0102204773 VA Primary

Addresses

Primary practice location

5115 Bernard Dr Ste 201
Roanoke, VA 24018-4367

Mailing address

PO Box 13306
Roanoke, VA 24032-3306
Phone (540) 345-0289

Other identifiers 2

IdentifierTypeStateIssuer
1881648707MedicaidWV
1881648707MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170801002239 VA Practitioner - Anesthesiology 9931120177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acv IncGroup PAC ID 3870633936, 70 clinicians

Practice addresses (Care Compare)

5115 Bernard Dr
Suite 201
Roanoke, VA 24018-4367
Phone (540) 345-0289

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
010816NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Acv Inc Anesthesiology CurrentSince Aug 1, 2017 Accepting new patients
Anesthesiology Consultants of Virginia, Inc Anesthesiology PastSince Aug 1, 2017 Accepting new patients
Carilion Emergency Services, Inc. Past Accepting new patients
Carilion Emergency Services, Inc. PastSince Dec 17, 2023 Accepting new patients

Locations

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

5115 Bernard Dr
Ste 201
Roanoke, VA 24018
Phone (540) 345-0289

Organizations & group practices 4

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 1

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1881648707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13306",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240323306",
            "telephone_number": "540-345-0289",
            "fax_number": "540-345-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 BERNARD DR STE 201",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184367",
            "telephone_number": "540-345-0289",
            "fax_number": "540-345-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0102204773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881648707",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881648707",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.