Individual provider Active NPI

Sandra Charlene Thompson, FNP

  • Family Nurse Practitioner
  • Cookeville, TN
National Provider Identifier
1992715874
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN5665 Issued in TN
Practice address
3300 Williams Enterprise Dr
Suite 1
Cookeville, TN 38506
Phone
(931) 528-9222
Fax
(931) 854-0907
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN5665 TN Primary

Addresses

Primary practice location

3300 Williams Enterprise Dr
Suite 1
Cookeville, TN 38506

Mailing address

3300 Williams Enterprise Dr.
Suite 1
Cookeville, TN 38506
Phone (931) 526-1050

Other identifiers 1

IdentifierTypeStateIssuer
3154952OtherTNBLUE CROSS BLUE SHEILD TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20080617000187 TN Practitioner - Nurse Practitioner 7911078167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Family Care, PLLC 5 clinicians

Practice addresses (Care Compare)

3300 Williams Enterprise Dr
Suite 1
Cookeville, TN 38506-4224
Phone 9315289222112

Hospital & facility affiliations

  • Quality Home Health Home health agency, Jamestown, TN, CCN 447406
  • Suncrest Home Health Home health agency, Smithville, TN, CCN 447176
  • Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5665TNMDSpeech-Language Pathologist
APN5665TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Family Care, PLLC CurrentSince Sep 12, 2022 Accepting new patients
Ambulatory Care Center of Wartburg Primary Care LLC Current Accepting new patients
Crossville Medical Group PA Past Accepting new patients
Tennessee Innovative Medical Services PLLC Past Accepting new patients
Cumberland Spine & Sport, LLC Past Accepting new patients
Fentress Family Care LLC PastSince Mar 22, 2020 Accepting new patients
Covenant Medical Group, Inc Past Accepting new patients

Locations

3300 Williams Enterprise Dr
Ste 1
Cookeville, TN 38506
Phone (931) 260-4770

Interoperability endpoints

  • Direct secure messaging: sthompson@innovativefamilycare.ssdirect.aprima.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1992715874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 WILLIAMS ENTERPRISE DR.",
            "address_2": "SUITE 1",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "38506",
            "telephone_number": "931-526-1050",
            "fax_number": "931-526-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WILLIAMS ENTERPRISE DR",
            "address_2": "SUITE 1",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "38506",
            "telephone_number": "931-528-9222",
            "fax_number": "931-854-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SANDRA",
        "middle_name": "CHARLENE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN5665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD TN",
            "identifier": "3154952",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.