Individual provider Active NPI

William R. Thompson III, MD

  • Pediatric Surgery Physician
  • Orlando, FL
National Provider Identifier
1942265277
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
ME74661 Issued in FL
Practice address
2501 N Orange Ave
Suite 200
Orlando, FL 32804-4603
Phone
(407) 303-7280
Fax
(407) 303-7265
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME74661 FL
Surgical Critical Care Physician 2086S0102X ME74661 FL
Pediatric Surgery Physician 2086S0120X ME74661 FL Primary

Addresses

Primary practice location

2501 N Orange Ave
Suite 200
Orlando, FL 32804-4603

Mailing address

2501 N Orange Ave
Suite 200
Orlando, FL 32804-4603
Phone (407) 303-7280

Other identifiers 1

IdentifierTypeStateIssuer
2501376-00MedicaidFL

Other names 1

  • W. Raleigh Thompson III Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090916000567 FL Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 3779639794 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Surgery CurrentSince Jul 1, 2009 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jul 1, 2009 Accepting new patients

Locations

1530 Celebration Blvd
Ste 408
Celebration, FL 34747
Phone (407) 392-2777

305 Memorial Medical Pkwy
Ste 408
Daytona Beach, FL 32117

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

6609 N Wickham Rd
Ste 104
Melbourne, FL 32940
Phone (407) 303-7280

2501 N Orange Ave
Ste 200
Orlando, FL 32804
Phone (407) 303-7265

2501 N Orange Ave
Ste 240
Orlando, FL 32804
Phone (407) 303-1380

Interoperability endpoints

  • Direct secure messaging: wthompson73762@adventhealth.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1942265277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-303-7280",
            "fax_number": "407-303-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-303-7280",
            "fax_number": "407-303-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "WILLIAM",
        "middle_name": "R.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME74661",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME74661",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "FL",
            "license": "ME74661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2501376-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "W.",
            "last_name": "THOMPSON",
            "middle_name": "RALEIGH",
            "suffix": "III",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.