Individual provider Active NPI

John K Thompson, DO

  • General Practice Physician
  • Hattiesburg, MS
National Provider Identifier
1962511212
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19031 Issued in MS
Practice address
6169 U S Highway 98
Ste 30
Hattiesburg, MS 39402-8634
Phone
(601) 336-8368
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 19031 MS
Public Health & General Preventive Medicine Physician 2083P0901X 19031 MS
Vascular Surgery Physician 2086S0129X 19031 MS
General Practice Physician 208D00000X 19031 MS Primary

Addresses

Primary practice location

6169 U S Highway 98
Ste 30
Hattiesburg, MS 39402-8634

Mailing address

6169 U S Highway 98
Ste 30
Hattiesburg, MS 39402-8634
Phone (601) 336-8368

Other identifiers 2

IdentifierTypeStateIssuer
09006590MedicaidMS
3415028OtherMSAMERICAN ADMIN GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kthompson2150@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20050811000529 MS Practitioner - Vascular SurgeryPractitioner - General Surgery 5698704435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Kansas City College of Medicine and Surgery, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6169 U S Hwy 98
Suite 30
Hattiesburg, MS 39402-8634
Phone (601) 336-8368

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal933

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19031MSMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vein Institute of South Mississippi PLLC Vascular Surgery CurrentSince Dec 1, 2021 Accepting new patients
FGH Physician Billing CurrentSince Dec 4, 2012 Accepting new patients

Locations

3950 Promenade Pkwy
Ste E
Diberville, MS 39540
Phone (228) 392-1960

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

6169 U S Highway 98
Ste 30
Hattiesburg, MS 39402
Phone (601) 336-8368

801 Goodyear Blvd
Picayune, MS 39466
Phone (601) 749-0688

Interoperability endpoints

  • Direct secure messaging: kthompson2150@directpatientrecord.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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1962511212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6169 U S HIGHWAY 98",
            "address_2": "STE 30",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028634",
            "telephone_number": "601-336-8368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6169 U S HIGHWAY 98",
            "address_2": "STE 30",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028634",
            "telephone_number": "601-336-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MS",
            "license": "19031",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MS",
            "license": "19031",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MS",
            "license": "19031",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MS",
            "license": "19031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09006590",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "3415028",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kthompson2150@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "415 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394017246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.