Provider Demographics
NPI:1447265988
Name:PETER THOMPSON, M.D., LLC
Entity type:Organization
Organization Name:PETER THOMPSON, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-463-8107
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0670
Mailing Address - Country:US
Mailing Address - Phone:609-463-8107
Mailing Address - Fax:609-463-8106
Practice Address - Street 1:1925 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-6713
Practice Address - Country:US
Practice Address - Phone:609-646-2818
Practice Address - Fax:609-646-2925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04898900208600000X, 2086S0127X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ14987OtherUNIVERSITY HEALTH PLANS
NJ2229041000OtherAMERIHEALTH
NJ1167806OtherHORIZON MERCY HEALTH PLAN
NJ6031803Medicaid
NJ=========OtherTRICARE / CHAMPUS
NJ=========OtherCIGNA
NJ6031803Medicaid
NJ14987OtherUNIVERSITY HEALTH PLANS
NJ2229041000OtherAMERIHEALTH
NJ14987OtherUNIVERSITY HEALTH PLANS
NJ=========OtherTRICARE / CHAMPUS