Autumn M Thompson, MS, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L004270 Issued in NC

Practice address

101 Bodin Cir BLDG 777
Travis Afb, CA 94535-1809

Phone

(707) 423-3667

NPI assigned

Feb 18, 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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1952725590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR BLDG 777",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR BLDG 777",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15453 Bobwhite Quail",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782536621",
            "country_code": "US",
            "telephone_number": "252-241-0369",
            "fax_number": "888-813-7814",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Wilford Hall Loop Bldg 4554",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "78236",
            "country_code": "US",
            "telephone_number": "210-292-6365",
            "fax_number": "210-292-4915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "AUTUMN",
        "middle_name": "M",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenhall Elmer Taylor III, M.D.
• Shanceline Esom Tebo
• The Janz Corporation
• Adrianne Kamara Thompson, M.D.
• Andrew Thompson, IDMT
• Ashley Quinn Thorburn, M.D.
• Emily M Tibbits, MD
• Reade Tillman, MD
• Florence Ann Tiscareno, RD
• Robert Lara Tong, M.D.

• Registered Dietitian in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.