Active NPI
Colby Thompson, CNP
- Gerontology Nurse Practitioner
- Rogers, AR
National Provider Identifier
1982277505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 213429
- Practice address
- 2710 S Rife Medical LN
Rogers, AR 72758-1452 - Phone
- (479) 636-0200
- Fax
- (479) 986-3448
- NPI assigned
- Jul 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 201953 | OK | |
| Gerontology Nurse Practitioner | 363LG0600X | 201953 | OK | |
| Gerontology Nurse Practitioner | 363LG0600X | 213429 | AR | Primary |
Addresses
Primary practice location
2710 S Rife Medical LN
Rogers, AR 72758-1452
Mailing address
2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 636-0200
Other practice location 1
300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 682-5501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201001900A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201953 | OK | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients |
Locations
3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100
2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Rogers, AR
- NPI 1265490916
-
- Hospitalist Physician
- Rogers, AR
- NPI 1699076737
-
- Multi-Specialty Clinic/Center
- Bella Vista, AR
- NPI 1396173514
-
- Endocrinology, Diabetes & Metabolism Physician
- Rogers, AR
- NPI 1770087371
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665532800000",
"number": "1982277505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2710 S RIFE MEDICAL LN",
"city": "ROGERS",
"state": "AR",
"postal_code": "727581452",
"telephone_number": "479-636-0200",
"fax_number": "479-986-3448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 S RIFE MEDICAL LN",
"city": "ROGERS",
"state": "AR",
"postal_code": "727581452",
"telephone_number": "479-636-0200",
"fax_number": "479-986-3448"
}
],
"practiceLocations": [
{
"address_1": "300 Rockefeller Dr",
"address_purpose": "LOCATION",
"city": "Muskogee",
"state": "OK",
"postal_code": "744015075",
"country_code": "US",
"telephone_number": "918-682-5501",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMPSON",
"first_name": "COLBY",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-21",
"last_updated": "2022-10-12",
"certification_date": "2022-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "OK",
"license": "201953",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "OK",
"license": "201953",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "AR",
"license": "213429",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201001900A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.