Individual provider Active NPI

Thomas C Dempster, LPA

  • Psychologist
  • Fayetteville, NC
National Provider Identifier
1063560670
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2577 Ravenhill Dr
Fayetteville, NC 28303-5451
Phone
(910) 309-7979
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2513 NC
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

2577 Ravenhill Dr
Fayetteville, NC 28303-5451

Mailing address

PO Box 87705
2525 Raeford Road Suite C
Fayetteville, NC 28304-7705
Phone (910) 309-7979

Other identifiers 1

IdentifierTypeStateIssuer
6107349MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2513NCMDMental Health Counselor
1037NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Healthcare Services, PA Mental Health CurrentSince Jul 1, 2022 Accepting new patients

Locations

2577 Ravenhill Dr
Fayetteville, NC 28303
Phone (910) 438-0947

821 S Main St
Laurinburg, NC 28352
Phone (910) 266-0092

19 E Front St
Lillington, NC 27546
Phone (910) 814-1560

109 Campus Ave
Raeford, NC 28376
Phone (910) 848-2400

307 W Rose St
Sanford, NC 27330
Phone (919) 292-1092

15 Noble St
Smithfield, NC 27577
Phone (919) 322-9337

Organizations & group practices 1

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1063560670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87705",
            "address_2": "2525 RAEFORD ROAD SUITE C",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283047705",
            "telephone_number": "910-309-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 RAVENHILL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035451",
            "telephone_number": "910-309-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMPSTER",
        "first_name": "THOMAS",
        "middle_name": "C",
        "credential": "LPA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2513",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107349",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.