Individual provider Active NPI

Andrea Ruth Thompson, MS, RD, LDN

  • Registered Dietitian
  • Macomb, IL
National Provider Identifier
1942676192
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164005111 Issued in IL
Practice address
1600 E Jackson St
Macomb, IL 61455-2530
Phone
(309) 837-9917
NPI assigned
Aug 11, 2015
Last updated
Aug 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164005111 IL Primary

Addresses

Primary practice location

1600 E Jackson St
Macomb, IL 61455-2530

Mailing address

1600 E Jackson St
Macomb, IL 61455-2530
Phone (309) 837-9917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170113001501 IL Practitioner - Registered Dietitian Or Nutrition Professional 9436431012 Reassigns benefits to 1 organization
I20240905000390 IA Practitioner - Registered Dietitian Or Nutrition Professional 9436431012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hy-Vee Health PCGroup PAC ID 1254701618, shared by 8 NPIs, 43 clinicians

Practice addresses (Care Compare)

1600 E Jackson St
Macomb, IL 61455-2530
Phone (515) 695-3121

4605 Fleur Dr
Des Moines, IA 50321-2333
Phone (515) 225-2930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Hy-Vee Health PC CurrentSince Jan 22, 2024 Accepting new patients
Hy-Vee Health PC Dietitian, Registered CurrentSince Jan 22, 2024 Accepting new patients
Hy-Vee Health PC Dietitian, Registered CurrentSince Jun 9, 2024 Accepting new patients
Hy-Vee Health PC Current Accepting new patients

Locations

4605 Fleur Dr
Des Moines, IA 50321
Phone (515) 285-7133

5820 Westown Pkwy
West Des Moines, IA 50266
Phone (515) 453-2784

7300 Westown Pkwy
Ste 320
West Des Moines, IA 50266
Phone (402) 896-5000

1 E Erie St
Ste 640
Chicago, IL 60611
Phone (312) 988-9300

1600 E Jackson St
Macomb, IL 61455
Phone (309) 833-3750

Organizations & group practices 4

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": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1942676192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552530",
            "telephone_number": "309-837-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552530",
            "telephone_number": "309-837-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ANDREA",
        "middle_name": "RUTH",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.