Clark Robert Thompson, MA

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

86 W Sunbridge Dr
Fayetteville, AR 72703-1822

Phone

(479) 435-6360

NPI assigned

Sep 4, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Associated Clinical Psychologists, LTD

  • Clinical Psychologist
  • Park Ridge, IL
  • NPI 1578665147
  Medicare reassignment NPD
• Red Neuron Group, PLLC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1801640131
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1003284274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CENTRAL AVE",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933006",
            "telephone_number": "847-441-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 W SUNBRIDGE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031822",
            "telephone_number": "479-435-6360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "IL",
            "postal_code": "600933006",
            "country_code": "US",
            "telephone_number": "847-441-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CLARK",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-04",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "1810AP-PL",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Kay Thompson-Neeser
• Andrea L Thompson, PA-C
• Chelsea Thompson, PHARM.D.
• Chelsea Thompson
• Chelsea Rush Thompson, AGPCNP-BC
• Cody Thompson, MD
• Jasmine Thompson, DC
• Lauren N Thompson, M.D.
• Leigh Thompson, M.S., CCC-SLP
• Lisa Aimee Thompson, LPC,CRC,PHD

• Student in an Organized Health Care Education/Training Program in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Student in an Organized Health Care Education/Training Program in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.