DR. SHELLY HOLDER THOMPSON (NPI# 1821054560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821054560 |
| Entity Type | Individual |
| Full Name | DR. SHELLY HOLDER THOMPSON |
| Credential | M.D. |
| Practice Address |
120 King St Jacksonville FL 32204-2410 |
| Mailing Address |
120 King Street Jacksonville FL 32204-2410 |
| Practice Telephone | (904) 760-4904 |
| Practice Fax Number | 9047604250 |
| Mailing Telephone | (904) 760-4904 |
| Mailing Fax Number | 9047604250 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2017-08-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | ME38917 | FL | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | ME0038917 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 0662089-00 | 05 | |
| FL | 066208900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942212535 | Shelly Lynn Thompson | Counselor | 5121 69th St Ste B711, Lubbock, TX 79424-1645 | 2006-08-12 |
| 1669005377 | Shelly M Thompson | Counselor | 601 S Rancho Dr Ste A10, Las Vegas, NV 89106-4898 | 2020-02-20 |
| 1811108566 | Shelly K Thompson | Pediatrics | 2308 E Main St, Suite G, New Iberia, LA 70560-4041 | 2007-05-24 |
| 1679689707 | Shelly Jane Thompson | Nurse Anesthetist, Certified Registered | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9756 | 2006-08-22 |
| 1275507634 | Shelly L Thompson | Obstetrics & Gynecology | 135 N Ewing St, Suite 205, Lancaster, OH 43130 | 2006-02-14 |
| Street Address |
120 KING ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295718104 | Christine J Trunk | Dentist | 120 King St, Jacksonville, FL 32204-2410 | 2005-11-23 |
| 1336781772 | Wendy Lynn King | Nurse Practitioner | 120 King St, Jacksonville, FL 32204-2410 | 2019-10-16 |
| 1497269880 | Jau R Evans | Nurse Practitioner | 120 King St, Jacksonville, FL 32204-2410 | 2017-11-22 |
| 1225576499 | Shaunetra Toler | Nurse Practitioner | 120 King St, Jacksonville, FL 32204-2410 | 2017-02-07 |
| 1053863746 | Charles Emerson | Physician Assistant | 120 King St, Jacksonville, FL 32204-2410 | 2016-10-27 |
| 1992154181 | Agape Community Health Center Inc | Pharmacy | 120 King St, Jacksonville, FL 32204-2410 | 2016-06-08 |
| 1962867762 | Agape Community Health Center, Inc. | Clinic/Center | 120 King St, Jacksonville, FL 32204-2410 | 2015-12-21 |
| 1447621420 | Judith Hepburn | Nurse Practitioner | 120 King St, Jacksonville, FL 32204-2410 | 2015-10-15 |
| 1043631435 | Shelly Anthony | Dental Hygienist | 120 King St, Jacksonville, FL 32204-2410 | 2014-01-02 |
| 1205013232 | Florida Department of Health | Public Health or Welfare | 120 King St, Mc 75, Jacksonville, FL 32204-2410 | 2008-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396369187 | Im Sulzbacher Center for The Homeless, Inc | Pediatrics | 5455 Springfield Blvd, Jacksonville, FL 32208-5166 | 2020-06-08 |
| 1609334515 | Jeremy N Harris, M.d., P.a. | Pediatrics | 3636 University Blvd S Ste B3, Jacksonville, FL 32216-4223 | 2019-03-10 |
| 1851856975 | Aksharbrahma Pa | Pediatrics | 6100 Greenland Rd Ste 301, Jacksonville, FL 32258-2626 | 2019-02-02 |
| 1184116972 | North Florida Pediatrics, Pa | Pediatrics | 9770 Old Bay Meadows Road, Suite 101, Jacksonville, FL 32256-7986 | 2018-06-06 |
| 1235654781 | Gabriella Assi, Md, LLC | Pediatrics | 5851 Saint Augustine Rd, Jacksonville, FL 32207-8015 | 2017-08-06 |
| 1417478629 | Johana Beatriz Gimenez | Pediatrics | 15 Founders Ln Ste 100, Jacksonville, IL 62650-3924 | 2017-06-28 |
| 1386185932 | Myrna B Ginter | Pediatrics | 3805 Ortega Blvd, Jacksonville, FL 32210-4415 | 2017-03-15 |
| 1831639400 | Children's Health Associates | Pediatrics | 3710 Grandy Ave, Jacksonville, FL 32207-6112 | 2017-03-02 |
| 1770039687 | Hampton Pediatrics Pa | Pediatrics | 11512 Lake Mead Ave Unit 201, Jacksonville, FL 32256-9688 | 2016-08-30 |
| 1447508478 | Starfish Pediatrics Pa | Pediatrics | 4500 Hodges Blvd, Suite 1, Jacksonville, FL 32224-2207 | 2012-08-23 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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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.