Trent Logan Thompson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070026451 Issued in IL

Practice address

2950 W Westridge PL
Carbondale, IL 62901-1092

Phone

(618) 457-1010

NPI assigned

Feb 17, 2022

Last updated

Feb 17, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Preferred Podiatry Group PC

  • Podiatrist
  • Oak Harbor, WA
  • NPI 1720037138
  NPD (past)
• Robert Marriott Medical Corp

  dba Advantage Wound Care

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938
  NPD (past)

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1902551948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WEISBROOK LN",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629182319",
            "telephone_number": "618-384-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 W WESTRIDGE PL",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011092",
            "telephone_number": "618-457-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TRENT",
        "middle_name": "LOGAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070026451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Thomas
• Mike Thomas, PHARMACIST
• Myranda Nicole Thomas
• Edward Brent Thompson, ATC
• Madison Thompson, BSW
• Justin Keith Thorpe, MD,DC
• Shannon Rae Throgmorton
• Rosemary Lynn Ticer, COTA/L
• Brittany Perrotta Tillman, MSW,LCSW
• Jennifer Ting, CNM

• Physical Therapist in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.