Individual provider Active NPI

Thomas Robert Cardwell, PSYCHOLOGIST

  • Counseling Psychologist
  • Lincoln, NE
National Provider Identifier
1003572249
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
610 Issued in NE
Practice address
2300 S 16TH St
Lincoln, NE 68502-3704
Phone
(402) 481-5454
NPI assigned
Nov 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 610 NE Primary

Addresses

Primary practice location

2300 S 16TH St
Lincoln, NE 68502-3704

Mailing address

2300 S 16TH St
Lincoln, NE 68502-3704
Phone (402) 481-5454

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.bryanhealth.com/clp-bariatrics/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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

Enrollment IDStateProvider typePAC IDDetails
I20220308002545 NE Practitioner - Clinical Psychologist 7618361676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Medical CenterGroup PAC ID 4284628652, 50 clinicians

Practice addresses (Care Compare)

2221 S 17TH St
201 Bryan Medical Center Counseling Center
Lincoln, NE 68502-3700
Phone (402) 481-5991

2300 S 16TH St
Lincoln, NE 68502-3704
Phone (402) 475-1011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
610NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Medical Center Counseling CurrentSince Dec 7, 2021 Accepting new patients
Bryan Medical Center Current Accepting new patients
Bryan Medical Center CurrentSince Dec 7, 2021 Accepting new patients

Locations

1600 S 48th St
Lincoln, NE 68506
Phone (402) 481-9049

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

2221 S 17th St
Ste 201
Lincoln, NE 68502
Phone (402) 481-5991

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1003572249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S 16TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023704",
            "telephone_number": "402-481-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S 16TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023704",
            "telephone_number": "402-481-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDWELL",
        "first_name": "THOMAS",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NE",
            "license": "610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.bryanhealth.com/clp-bariatrics/",
            "affiliation": "N",
            "endpointDescription": "Bryan Medical Center Counseling Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health and Mental Health Information",
            "address_1": "2300 S0. 16th St.",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685023780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.