Provider Demographics
NPI:1225326945
Name:THOMPSON, ANNA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8424 S 160TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-1336
Mailing Address - Country:US
Mailing Address - Phone:402-310-4102
Mailing Address - Fax:
Practice Address - Street 1:9851 S 71ST PLZ
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68133
Practice Address - Country:US
Practice Address - Phone:402-686-2396
Practice Address - Fax:402-339-9804
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1449152WP0200X, 152W00000X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47082635804Medicaid