Provider Demographics
NPI:1083722599
Name:THOMPSON, CARA JANINE (OD)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:JANINE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CARA
Other - Middle Name:JANINE
Other - Last Name:HELIKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:14163 PINE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-1060
Mailing Address - Country:US
Mailing Address - Phone:402-778-1240
Mailing Address - Fax:
Practice Address - Street 1:7904 S 83RD ST
Practice Address - Street 2:
Practice Address - City:LAVISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-2774
Practice Address - Country:US
Practice Address - Phone:402-597-8990
Practice Address - Fax:402-597-8992
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1072152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025067600Medicaid
NE16478OtherSPECTERA PROVIDER NUMBER
NEU57581Medicare UPIN
NE276212Medicare ID - Type Unspecified