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DR. SHELLY HOLDER THOMPSON M.D.
NPI 1821054560
Pediatrics in Jacksonville, FL

Active since April 21, 2006PECOS Enrolled
120 KING ST, JACKSONVILLE, FL 32204(904) 760-4904(904) 760-4250 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 21, 2022, Aug 10, 2017 (2 updates tracked since 2017).

About Dr. Shelly Holder Thompson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHELLY HOLDER THOMPSON M.D. (NPI 1821054560) is an individual pediatrics provider in Jacksonville, Florida, licensed in Florida (ME38917) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821054560
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. SHELLY HOLDER THOMPSONCredential: M.D.
Location Address120 KING STJacksonville, FL 32204-2410
Mailing Address120 King StreetJacksonville, FL 32204-2410 · (904) 760-4904 · Fax (904) 760-4250
Phone(904) 760-4904
Fax(904) 760-4250
Sole ProprietorNo
Enumeration DateApril 21, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1821054560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in FL · ME38917✔ Licensed in FL · ME0038917
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
120 KING ST, Jacksonville, FL 32204
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Other Identifiers 2

Medicaid066208900FL
Medicaid0662089-00FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shelly Holder Thompson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shelly Thompson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Im Sulzbacher Center For The Homeless, Inc
2.9 mi
Federally Qualified Health Center (FQHC)
611 E ADAMS ST
Jacksonville, FL 32202
  • Reassigned Medicare billing, Florida enrollment
  • 31 clinicians in this Medicare group
NPI 1710051354 (904) 394-8070

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KNETRA PENDLETON APRN
Nurse Practitioner (Pediatrics)
120 KING ST
JACKSONVILLE, FL 32204
Duval County (904) 760-4904
MISS SHELLY ANTHONY RDH
Dental Hygienist
120 KING ST
JACKSONVILLE, FL 32204
Duval County (904) 253-1287
FLORIDA DEPARTMENT OF HEALTH
Clinic/Center (Federally Qualified Health Center (FQHC))
120 KING ST, MC 75
JACKSONVILLE, FL 32204
Duval County (904) 253-2785
PAULA LYNN TWYMAN FNP-BC
Nurse Practitioner (Family)
120 KING ST
JACKSONVILLE, FL 32204
Duval County (904) 760-4904
DR. CHRISTINE J TRUNK DDS
Dentist
120 KING ST
JACKSONVILLE, FL 32204
Duval County (904) 253-1287
MS. JENNIFER AUERBACH HIPP D.O.
Pediatrics
120 KING ST
JACKSONVILLE, FL 32204
Duval County (904) 760-4904
WENDY LYNN KING APRN
Nurse Practitioner (Pediatrics)
120 KING ST
JACKSONVILLE, FL 32204
Duval County (904) 760-4904
JUDITH HEPBURN ARNP
Nurse Practitioner (Pediatrics)
120 KING ST
JACKSONVILLE, FL 32204
Duval County (904) 760-4904

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shelly Thompson's NPI number?

The NPI number for Shelly Thompson is 1821054560. It was assigned to this individual provider in the NPPES registry on April 21, 2006.

Where is Shelly Thompson located?

Shelly Thompson practices at 120 King St, Jacksonville, FL 32204. The listed phone number is (904) 760-4904.

What is Shelly Thompson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Shelly Thompson enrolled in Medicare?

Yes. Shelly Thompson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shelly Thompson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shelly Thompson reassigns Medicare benefits to Im Sulzbacher Center For The Homeless, Inc (Jacksonville, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shelly Thompson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shelly Thompson accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 3 other insurers list Shelly Thompson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shelly Thompson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.