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NPI Code Detail

MEDICARE: ELLEN THOMPSON

MEDICARE: ELLEN THOMPSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist6036NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356411631
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN THOMPSON
Provider Business Mailing Address
First Line : 200 BROADHURST RD
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-3551
Country : US
Telephone Number : 910-455-2211
Fax Number :
Provider Business Practice Location Address
First Line : 200 BROADHURST RD
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-3551
Country : US
Telephone Number : 910-455-2211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 06/04/2026

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Directions to “ ELLEN THOMPSON ” Practice Location

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