Thompson First Surgical Assisting

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

2222 Issued in KY

Legal business name

THOMPSON FIRST SURGICAL ASSISTING

Practice address

138 Raven Dr
Berea, KY 40403

Phone

(859) 200-3356

Fax

(502) 451-9291

NPI assigned

May 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Glen Thompson III, CSANPI 1629299268

Title

Owner

Phone

(859) 200-3356

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glen Thompson III, CSA

  • Surgical Technologist
  • Berea, KY
  • NPI 1629299268
  NPD (past) Authorized official

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881816130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 RAVEN DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "40403",
            "telephone_number": "859-200-3356",
            "fax_number": "502-451-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 RAVEN DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "40403",
            "telephone_number": "859-200-3356",
            "fax_number": "502-451-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMPSON FIRST SURGICAL ASSISTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-200-3356",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "CSA"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "KY",
            "license": "2222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000493588",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgical Technologist in Berea, KY
• Providers in Berea, KY by specialty
• Surgical Technologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.