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NPI Code Detail

MEDICARE: SUMMER NICOLE THOMPSON PA

MEDICARE: SUMMER NICOLE THOMPSON PA
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
1363A00000XPhysician Assistant3514AZ
2363AM0700XMedical Physician Assistant3514AZ
3363AS0400XSurgical Physician Assistant3514AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15550830010OTHERAZMEDICARE NSC GILBERT
25550830003OTHERAZMEDICARE NSC PEORIA
35550830001OTHERAZMEDICARE NSC SCW
45550830009OTHERAZMEDICARE NSC AZ NORTH
65550830007OTHERAZMEDICARE NSC DV
75550830004OTHERAZMEDICARE NSC PV
85550830006OTHERAZMEDICARE NSC ANTHEM
95550830008OTHERAZMEDICARE NSC SWV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760563399
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUMMER NICOLE THOMPSON PA
Provider Business Mailing Address
First Line : 18444 N 25TH AVE
Second Line : SUITE 310
City : PHOENIX
State : AZ
Zip : 85023-1261
Country : US
Telephone Number : 623-537-5600
Fax Number : 623-537-5601
Provider Business Practice Location Address
First Line : 18444 N 25TH AVE
Second Line : SUITE 210
City : PHOENIX
State : AZ
Zip : 85023-1261
Country : US
Telephone Number : 866-974-2673
Fax Number : 866-939-2673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 04/18/2024

Similar Medicare Providers

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1568415388 — DANIAL A NEAL P.T.
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1285702464 — MRS. CHRISTINA L.S. WILLMAN PA-C
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1407904170 — DR. GAGANDEEP SINGH ARORA D.C.
Practice Location Address:
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1609993179 — MONA VIJAY MHATRE DO
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Directions to “ SUMMER NICOLE THOMPSON PA” Practice Location

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