Provider Demographics
NPI:1962544924
Name:THOMPSON, JAMES LLEWELLYN (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LLEWELLYN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6737 CODY ST # B
Mailing Address - Street 2:
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-8504
Mailing Address - Country:US
Mailing Address - Phone:208-267-2225
Mailing Address - Fax:
Practice Address - Street 1:6737 CODY ST # B
Practice Address - Street 2:
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805-8504
Practice Address - Country:US
Practice Address - Phone:208-267-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA 619111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP00106895OtherRR MEDICARE
ID000010021339OtherREGENCE BLUE SHIELD
ID2099279OtherFIRST HEALTH NETWORK
ID806994800Medicaid
IDC6194OtherBLUE CROSS OF IDAHO
IDC6194OtherBLUE CROSS OF IDAHO