NPIMap

Individual provider Active NPI

Kenneth Allan Thompson, M.D.

  • Emergency Medicine Physician
  • Southaven, MS
National Provider Identifier
1992793251
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
19372 Issued in MS
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(662) 772-3260
NPI assigned
Oct 11, 2005
Last updated
Jan 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00025767 AL
Emergency Medicine Physician 207P00000X 19372 MS Primary
Emergency Medicine Physician 207P00000X 41139 TN

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

PO Box 634706
Cincinnati, OH 45263-4706
Phone (662) 772-3260

Other identifiers 4

IdentifierTypeStateIssuer
3829824MedicaidTN
4133803OtherTNBLUE CROSS
07781813MedicaidMS
P00388668OtherTNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070110000363 MS Practitioner - Emergency Medicine 5799759650 Reassigns benefits to 3 organizations
I20070220000644 TN Practitioner - Emergency Medicine 5799759650 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Alabama School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist University Emergency Physicians PLLCGroup PAC ID 4981052719, 40 clinicians
Olive Branch Emergency Physicians LLCGroup PAC ID 9335598739, 27 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Memphis, TN 38104-3415
Phone (901) 516-7000

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (662) 932-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00025767ALMDEmergency Medicine Physician
41139TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist University Emergency Physicians PLLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Germantown Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Carr PLLC Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
Methodist South Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Olive Branch Emergency Physicians LLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Methodist North Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
T M Carr MD PC Emergency Medicine CurrentSince Jun 12, 2024 Accepting new patients
Keith Van Meter & Associates Past Accepting new patients
Southern Medical Group, Inc Emergency Medicine Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Tennessee Emergency Physicians, PLLC Emergency Medicine PastSince Feb 9, 2020 Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: kthompson28991@mlh.direct-ci.com

Organizations & group practices 12

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.

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1992793251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634706",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452634706",
            "telephone_number": "662-772-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "662-772-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KENNETH",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00025767",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "19372",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "41139",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3829824",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4133803",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07781813",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00388668",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.