Active NPI
Thomas Monroe Rayburn III, PH.D.
- Clinical Psychologist
- Washington, DC
National Provider Identifier
1033329305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1000076
- Practice address
- 4001 Harewood Rd NE
126 O'Boyle Hall
Washington, DC 20064-0001 - Phone
- (202) 319-6323
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1000076 | DC | Primary |
| Clinical Psychologist | 103TC0700X | 03678 | MD |
Addresses
Primary practice location
4001 Harewood Rd NE
126 O'Boyle Hall
Washington, DC 20064-0001
Mailing address
4001 Harewood Rd NE
Washington, DC 20064-0001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2025 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1000076 | DC | MD | Clinical Psychologist |
| 03678 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1033329305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 HAREWOOD RD NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200640001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 HAREWOOD RD NE",
"address_2": "126 O'BOYLE HALL",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200640001",
"telephone_number": "202-319-6323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYBURN",
"first_name": "THOMAS",
"middle_name": "MONROE",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "DC",
"license": "1000076",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "03678",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.