Basic Information
| Provider Information | |||||||||
| NPI: | 1902828072 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMPSON | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | ON TAP HEALTH | ||||||||
| Address2: | 401 WATERFLOWER CIRCLE SUITE 201 | ||||||||
| City: | COLCHESTER | ||||||||
| State: | VT | ||||||||
| PostalCode: | 05446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8026988583 | ||||||||
| FaxNumber: | 8333881974 | ||||||||
| Practice Location | |||||||||
| Address1: | ON TAP HEALTH | ||||||||
| Address2: | 401 WATERFLOWER CIRCLE SUITE 201 | ||||||||
| City: | COLCHESTER | ||||||||
| State: | VT | ||||||||
| PostalCode: | 05446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8026988583 | ||||||||
| FaxNumber: | 8333881974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 01/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 0550030453 | VT | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 0AP1189 | 05 | VT | MEDICAID |