Individual provider Active NPI

Colby Thompson, CNP

  • Gerontology Nurse Practitioner
  • Rogers, AR
National Provider Identifier
1982277505
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
213429 Issued in AR
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

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
201001900AMedicaidOK

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221025001341 AR Practitioner - Nurse Practitioner 5890190607 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201953OKMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Oct 3, 2022 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Oct 3, 2022 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Oct 3, 2022 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.

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

Verify at the official NPI Registry.