Individual provider Active NPI

Thomas Gerald Brewer, PH.D.

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1033323563
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301009090 Issued in MI
Practice address
3200 W. Liberty Rd.
Suite a
Ann Arbor, MI 48103-9794
Phone
(734) 994-9181
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301009090 MI Primary
Clinical Child & Adolescent Psychologist 103TC2200X 6301009090 MI
Forensic Psychologist 103TF0200X 6301009090 MI

Addresses

Primary practice location

3200 W. Liberty Rd.
Suite a
Ann Arbor, MI 48103-9794

Mailing address

3200 W. Liberty Rd.
Suite a
Ann Arbor, MI 48103-9794
Phone (734) 994-9181

Other identifiers 1

IdentifierTypeStateIssuer
680H1480600OtherMIBLUE CROSS BLUE SHIELD NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120927000116 MI Practitioner - Clinical Psychologist 2567611080 Reassigns benefits to 1 organization
Practice locations: Ann Arbor, MI; Dearborn, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1207 Packard St
Suite S 2
Ann Arbor, MI 48104-3810
Phone (734) 711-3145

2881 Monroe St 2ND FL
Dearborn, MI 48124-3475
Phone (313) 359-1977

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Huron Valley Consultation Center Inc Clinical CurrentSince Sep 9, 2018 Accepting new patients
Center for Family Psychiatry, PLC CurrentSince Aug 6, 2018 Accepting new patients
Liberty Pediatrics PLLC Past Accepting new patients

Locations

2750 S State St
Ann Arbor, MI 48104
Phone (734) 662-1986

1235 Industrial Dr
Ste 4
Saline, MI 48176
Phone (734) 944-8300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7128/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1033323563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 W. LIBERTY RD.",
            "address_2": "SUITE A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039794",
            "telephone_number": "734-994-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W. LIBERTY RD.",
            "address_2": "SUITE A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039794",
            "telephone_number": "734-994-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "THOMAS",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009090",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301009090",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MI",
            "license": "6301009090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NO",
            "identifier": "680H1480600",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.