1. Home
  2. Directory
  3. California
  4. Santa Rosa
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

JEREMIAH THOMPSON
NPI 1831866615
Student in an Organized Health Care Education/Training Program in Santa Rosa, CA

Active since August 27, 2021PECOS Enrolled
1622 4TH ST, SANTA ROSA, CA 95404(707) 583-9777 Get Directions Write a Review

NPPES record last updated: August 27, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jeremiah Thompson NPPES

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

JEREMIAH THOMPSON (NPI 1831866615) is an individual student in an organized health care education/training program in Santa Rosa, California and active in the NPI registry since August 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1831866615
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJEREMIAH THOMPSON
Location Address1622 4TH STSanta Rosa, CA 95404-4020
Mailing Address1622 4th StSanta Rosa, CA 95404-4020
Phone(707) 583-9777
Sole ProprietorNo
Enumeration DateAugust 27, 2021
NPPES CertifiedAugust 27, 2021
✔ NPI 1831866615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1622 4TH ST, Santa Rosa, CA 95404
Open in Google Maps ↗

Other Names 1

Other Name (5)Jeremy Thompson

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeremiah Thompson 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 Jeremiah Thompson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kendall Individual Family And Marriage Therapists Inc
Same address
Marriage & Family Therapist
1622 4TH ST
Santa Rosa, CA 95404
  • Reassigned Medicare billing, California enrollment
  • 5 clinicians in this Medicare group
NPI 1740830389 (707) 571-1714

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

Other Providers at the Same Location NPPES 6

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

MRS. KATHERINE GRACE FLINN LCSW
Social Worker (Clinical)
1622 4TH ST
SANTA ROSA, CA 95404
Sonoma County (714) 488-4497
MRS. LINDA LEE KINZLER LCSW
Social Worker (Clinical)
1622 4TH ST
SANTA ROSA, CA 95404
Sonoma County (707) 479-7328
KENDALL INDIVIDUAL FAMILY AND MARRIAGE THERAPISTS INC
Marriage & Family Therapist
1622 4TH ST
SANTA ROSA, CA 95404
Sonoma County (707) 571-1714
TASIA ROBLES HENDERSON
Social Worker (Clinical)
1622 4TH ST
SANTA ROSA, CA 95404
Sonoma County (707) 216-1758
RHONDA C ROBERTSON
Marriage & Family Therapist
1622 4TH ST
SANTA ROSA, CA 95404
Sonoma County (707) 978-8089
RONALD JAMES BRAUNER
Student in an Organized Health Care Education/Training Program
1622 4TH ST
SANTA ROSA, CA 95404
Sonoma County (707) 919-3218

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 Jeremiah Thompson's NPI number?

The NPI number for Jeremiah Thompson is 1831866615. It was assigned to this individual provider in the NPPES registry on August 27, 2021. The provider is also known as Jeremy Thompson.

Where is Jeremiah Thompson located?

Jeremiah Thompson practices at 1622 4th St, Santa Rosa, CA 95404. The listed phone number is (707) 583-9777.

What is Jeremiah Thompson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jeremiah Thompson enrolled in Medicare?

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

Which organization bills Medicare for Jeremiah Thompson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeremiah Thompson reassigns Medicare benefits to Kendall Individual Family And Marriage Therapists Inc (Santa Rosa, CA). 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 Jeremiah Thompson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeremiah Thompson was last updated on August 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.