Individual provider Active NPI

Jerome W Thompson, MD

  • Pediatric Otolaryngology Physician
  • Memphis, TN
National Provider Identifier
1982660015
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
25322 Issued in TN
Practice address
51 N Dunlap St
Memphis, TN 38105
Phone
(901) 287-7337
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 25322 TN Primary

Addresses

Primary practice location

51 N Dunlap St
Memphis, TN 38105

Mailing address

51 N Dunlap St
Memphis, TN 38105-4625
Phone (901) 287-7337

Other identifiers 1

IdentifierTypeStateIssuer
3086217MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080725000659 TN Practitioner - Otolaryngology 5890868616 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25322TNMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. Pediatric Otolaryngology CurrentSince Dec 1, 2010 Accepting new patients

Locations

850 Poplar Ave
#2
Memphis, TN 38105

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

Interoperability endpoints

  • Direct secure messaging: jthompson27924@mlh.direct-ci.com

Organizations & group practices 1

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1982660015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054625",
            "telephone_number": "901-287-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38105",
            "telephone_number": "901-287-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JEROME",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "TN",
            "license": "25322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086217",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.