MARK EDMUND THOMPSON (NPI# 1487646030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487646030 |
| Entity Type | Individual |
| Full Name | MARK EDMUND THOMPSON |
| Credential | D.O. |
| Practice Address |
4520 W Us Highway 90 Lake City FL 32055-8341 |
| Practice Telephone | 3527550601 |
| Practice Fax Number | 3527550602 |
| Mailing Telephone | 3527550601 |
| Mailing Fax Number | 3527550602 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2016-03-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
OS10194 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AVMED | 310302 | 01 |
| FL | BLUE CROSS BLUE SHIELD | 02484 | 01 |
| OH | 0825156 | 05 | |
| FL | 279300800 | 05 | |
| FL | LINKED TO GROUP PTAN IE881A EFFECTIVE 08/01/2015 | PTAN AG644E | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631518 | Mark N Thompson | Counselor | 4608 79th Avenue Ct W, University Place, WA 98466-3042 | 2017-10-25 |
| 1750733119 | Mark Thompson | Podiatrist | 5109 Lexington Sq Ste 200, Amarillo, TX 79119-6571 | 2016-07-11 |
| 1790146843 | Mark Thompson | Acupuncturist | 119 W 57th St Ste 600, New York, NY 10019-2305 | 2016-03-17 |
| 1629225560 | Mark Andrew Thompson | Family Medicine | 201 S Elm St, White Pigeon, MI 49099-9706 | 2008-08-22 |
| 1962677922 | Mark Lee Thompson | Occupational Therapist | 403 2nd Ave Ste 101, Opelika, AL 36801-4382 | 2008-04-29 |
| 1376753533 | Mark Thompson | Counselor | 7 Elba Ct, Columbus, GA 31903-3301 | 2007-05-23 |
| 1508907627 | Mark Stephen Thompson | Dentist | 114 Campus Ave., Raeford, NC 28376-2606 | 2007-02-09 |
| 1881776912 | Mark Allan Thompson | Dentist | 701 S Main, Jacksonville, TX 75766 | 2006-10-19 |
| 1396856183 | Mark Anthony Thompson | Chiropractor | 11411 Hwy 231 N, Meridianville, AL 35759 | 2006-08-31 |
| 1467460501 | Mark Thompson | Chiropractor | 15230 Ne 24th St Ste 1-s, Redmond, WA 98052-5540 | 2006-08-04 |
| Street Address |
4520 W US HIGHWAY 90 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-8341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710964093 | Louise C Waszak | Nurse Practitioner | 4520 W Us Highway 90, Lake City, FL 32055-8341 | 2005-12-28 |
| 1467434654 | Martin I. Holzman | Radiology | 4520 W Us Highway 90, Lake City, FL 32055-8341 | 2005-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902893902 | North Florida Cancer Center Lake City LLC | Radiology | 795 Sw Highway 47, Lake City, FL 32025 | 2005-10-04 |
| 1114467586 | Carolinas Medical Alliance Inc | Radiology | 148 Sauls St, Suite F, Lake City, SC 29560-2677 | 2017-03-03 |
| 1467434654 | Martin I. Holzman | Radiology | 4520 W Us Highway 90, Lake City, FL 32055-8341 | 2005-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114539079 | Mydoctoreb LLC | Radiology | 17407 Lotino Pl, Lutz, FL 33548-4815 | 2020-08-20 |
| 1417516600 | Arthur J. Iglesias, M.d. P.a. | Radiology | 1100 N.w. 95th Street, Cancer Center, Miami, FL 33150 | 2019-06-11 |
| 1962970111 | William A Assad, M.d. | Radiology | 3202 Henderson Blvd Ste 204a, Tampa, FL 33609-3043 | 2018-11-06 |
| 1508361361 | Marian Ingram | Radiology | 350 Nw 84th Ave Ste 102, Plantation, FL 33324-1820 | 2018-03-26 |
| 1376051870 | Indian River Health Services Inc | Radiology | 3555 10th Ct Ste 101, Vero Beach, FL 32960-5013 | 2018-01-18 |
| 1417492497 | Flagler Hospital, Inc. | Radiology | 97 Health Park Blvd, Saint Augustine, FL 32086-5777 | 2016-12-29 |
| 1447614441 | Benjamin Spieler | Radiology | 1475 Nw 12th Ave # Sccc1500, Miami, FL 33136-1002 | 2016-04-06 |
| 1629461371 | Florida Oncology Tavares, LLC | Radiology | 2010 Nightingale Ln, Tavares, FL 32778-4361 | 2015-03-05 |
| 1285042036 | Gulf Region Radiation Oncology Centers | Radiology | 1545 Airport Blvd Ste 1000, Pensacola, FL 32504-8615 | 2014-07-24 |
| 1962812917 | Florida Oncology Partners LLC | Radiology | 1100 N.w. 95 Street, Cancer Center, Miami, FL 33150-2038 | 2014-04-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.