NPIMap

Individual provider Active NPI

Derek C Thompson, DMD

  • Dentist
  • Union Gap, WA
National Provider Identifier
1982822904
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
721548754 Issued in WA
Practice address
2100 S 14TH St
Union Gap, WA 98903-1252
Phone
(509) 457-6300
NPI assigned
Apr 23, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 721548754 WA Primary

Addresses

Primary practice location

2100 S 14TH St
Union Gap, WA 98903-1252

Mailing address

707 Beacon Ave
Yakima, WA 98901-1577
Phone (509) 457-6300

Other identifiers 1

IdentifierTypeStateIssuer
5038799MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
721548754WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pepsquad PLLC Dentist Current Accepting new patients
Thompson Ferguson Schrack PLLC Dentist Current Accepting new patients
Derek Thompson DMD Patrick Ferguson DDS Dentist Past Accepting new patients
Derek Thompson DMD Patrick Ferguson DDS PLLC Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982822904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 BEACON AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989011577",
            "telephone_number": "509-457-6300",
            "fax_number": "509-248-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S 14TH ST",
            "city": "UNION GAP",
            "state": "WA",
            "postal_code": "989031252",
            "telephone_number": "509-457-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DEREK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "721548754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5038799",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union Gap, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.