Healthcare Provider Details

I. General information

NPI: 1821926031
Provider Name (Legal Business Name): ANNA NOELLE THOMPSON OTD, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4002 KRESGE WAY
ST MATTHEWS KY
40207-4661
US

IV. Provider business mailing address

197 TANYARD PARK PL UNIT 78
LOUISVILLE KY
40229-4225
US

V. Phone/Fax

Practice location:
  • Phone: 502-896-7447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: