Individual provider Active NPI

Caitlin C Thompson, PH.D.

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1013436872
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
05911 Issued in MD
Practice address
707 N Broadway
Baltimore, MD 21205-1888
Phone
(410) 923-2971
NPI assigned
Sep 13, 2017
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 05911 MD Primary

Addresses

Primary practice location

707 N Broadway
Baltimore, MD 21205-1888

Mailing address

707 N Broadway
Baltimore, MD 21205-1888
Phone (443) 923-2971

Other practice location 1

9810 Patuxent Woods Dr Ste C
Columbia, MD 21046-1595
Phone (410) 923-2971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20231103000199 MD Practitioner - Clinical Psychologist 5092162602 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05911MDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Sep 16, 2023 Accepting new patients
Kennedy Krieger Associates CurrentSince Sep 16, 2023 Accepting new patients
Kennedy Krieger Children's Hospital, Inc. Past Accepting new patients

Locations

1741 Ashland Ave
Rm 646
Baltimore, MD 21205
Phone (443) 923-1842

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

9810 Patuxent Woods Dr
Ste C
Columbia, MD 21046
Phone (410) 290-6432

Interoperability endpoints

  • Direct secure messaging: cthompson419066@direct.hopkinsmedicine.org

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1013436872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051888",
            "telephone_number": "443-923-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051888",
            "telephone_number": "410-923-2971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9810 Patuxent Woods Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210461595",
            "country_code": "US",
            "telephone_number": "410-923-2971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CAITLIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.