Susan D. Thompson, M.D.
Individual provider Active NPI Family Medicine Physician · Clay Center, KS
NPI 1922009182 · NPPES record last updated Mar 20, 2017
Key facts
- NPI
- 1922009182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 04-21395 (KS)
- Practice address
- 617 Liberty St
Clay Center, KS 67432-1564 - Phone
- (785) 632-5184
- Fax
- (785) 632-2031
- NPI assigned
- Aug 9, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-21395 | KS | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 04-21395 | KS | Yes |
Addresses
Primary practice location
617 Liberty St
Clay Center, KS 67432-1564
Mailing address
PO Box 808
Clay Center, KS 67432-0808
Phone (785) 632-5184
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100151820B | Medicaid | KS |
Other providers in Clay Center, KS
- Courtnee Lynn Spillman
- Laura Sue Squires
- Tina Stillwell
- Jaacob Leigh Struffert
- Kayla Sulanka
- Tina Stillwell Lscsw, LLC
- Tlec Clay Washington Infant Toddler Program
- Usd 379 Clay Center
- Kendell Dwayne Varner
- Audra Walter
All providers in Clay Center, KS · Family Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.