Provider Demographics
NPI:1700889367
Name:THOMPSON, SHARI A (MD)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:A
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:821 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-2102
Mailing Address - Country:US
Mailing Address - Phone:660-826-4774
Mailing Address - Fax:660-827-8992
Practice Address - Street 1:1825 ATCHISON AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-9752
Practice Address - Country:US
Practice Address - Phone:660-886-8584
Practice Address - Fax:660-827-8992
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO109708208M00000X
MO108706207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO80117756OtherRAILROAD MEDICARE
MO1700889367Medicaid
MO1700889367Medicaid
MOG808210Medicare Oscar/Certification
MO80117756OtherRAILROAD MEDICARE