Healthcare Provider Details

I. General information

NPI: 1851552673
Provider Name (Legal Business Name): JENNIFER THOMPSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 ASHVILLE AVE
CARY NC
27518-6669
US

IV. Provider business mailing address

7750 MCCRIMMON PKWY STE 100
CARY NC
27519-1912
US

V. Phone/Fax

Practice location:
  • Phone: 919-859-1136
  • Fax: 919-859-4240
Mailing address:
  • Phone: 919-234-1577
  • Fax: 888-355-8929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA103819
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: