Individual provider Active NPI

Nathan F. Thompson, DMD

  • General Practice Dentistry
  • Scottsburg, IN
National Provider Identifier
1902928732
Registry record updated Nov 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12012218 Issued in IN
Practice address
30 W McClain Ave
Scottsburg, IN 47170-1847
Phone
(812) 752-4428
Fax
(812) 752-7887
NPI assigned
Apr 4, 2007
Last updated
Nov 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7412 KY
General Practice Dentistry 1223G0001X 12012218 IN Primary

Addresses

Primary practice location

30 W McClain Ave
Scottsburg, IN 47170-1847

Mailing address

2215 Portland Ave
Louisville, KY 40212-1033
Phone (502) 774-8631

Other identifiers 1

IdentifierTypeStateIssuer
7100331880MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720002909 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7911031018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012218INMDGeneral Practice Dentistry
7412KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Nathan Thompson, DMD, LLC CurrentSince Nov 15, 2020 Accepting new patients
DRS. McCall, Currens, Ralston & Topor General Practice Past Accepting new patients
Graf Family Dentistry, PSC General Practice Past Accepting new patients

Locations

30 W McClain Ave
Scottsburg, IN 47170
Phone (812) 752-4428

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604793600000",
    "number": "1902928732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 PORTLAND AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121033",
            "telephone_number": "502-774-8631",
            "fax_number": "502-772-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MCCLAIN AVE",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471701847",
            "telephone_number": "812-752-4428",
            "fax_number": "812-752-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "NATHAN",
        "middle_name": "F.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-11-08",
        "certification_date": "2020-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7412",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100331880",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsburg, IN

Sources for this page

Verify at the official NPI Registry.