Kevin Thompson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME89343 Issued in FL

Practice address

5530-1 Florida Mining Blvd. S
Jacksonville, FL 32257

Phone

(904) 826-5001

Fax

(904) 661-0021

NPI assigned

Mar 21, 2014

Sex

Female

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Nov 5, 2018 through Nov 5, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1942627476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 SAN RAFAEL ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320805348",
            "telephone_number": "904-540-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530-1 FLORIDA MINING BLVD. S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32257",
            "telephone_number": "904-826-5001",
            "fax_number": "904-661-0021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 A1A Beach Blvd",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320804728",
            "country_code": "US",
            "telephone_number": "904-826-5001",
            "fax_number": "904-661-0021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-21",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME89343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karissi Thompson
• Kayla Ann Thompson, FNP
• Kelly Thompson, CRNA
• Ken Edward Thompson, CRPS
• Kerry Anne Thompson, CRNA
• Kristine Thompson, MD
• Kyndra Thompson
• Lauren Ann Thompson
• Lisa Thompson, CNA
• Matthew James Thompson, M.D.

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.