Individual provider Active NPI

Rachel V. Tompkins, PH.D.

  • Clinical Psychologist
  • Edwardsville, IL
National Provider Identifier
1114039435
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
118 S Main St
Edwardsville, IL 62025-1904
Phone
(618) 656-0696
Fax
(618) 656-9697
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X IL Primary

Addresses

Primary practice location

118 S Main St
Edwardsville, IL 62025-1904

Mailing address

118 S Main St
Edwardsville, IL 62025-1904
Phone (618) 656-0696

Other identifiers 8

IdentifierTypeStateIssuer
IP167869OtherMAGELLAN INSURANCE ID NUM
9112714OtherPHCS INSURANCE ID NUMBER
6100116OtherILBC/BS ID NUMBER
90051OtherMHN INSURANCE ID NUMBER
158294OtherCOMPSYCH INSURANCE ID NUM
6189572OtherUBH INSURANCE ID NUMBER
A1015113OtherVALUE OPTIONS INSURANCE I
139120OtherHEALTHLINK INSURANCE ID N

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20121105000476 IL Practitioner - Clinical Psychologist 6305097189 Practice locations: Edwardsville, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

118 S Main St
Edwardsville, IL 62025-1904
Phone (618) 656-0696

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071-003442ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114039435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S MAIN ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251904",
            "telephone_number": "618-656-0696",
            "fax_number": "618-656-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S MAIN ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251904",
            "telephone_number": "618-656-0696",
            "fax_number": "618-656-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMPKINS",
        "first_name": "RACHEL",
        "middle_name": "V.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN INSURANCE ID NUM",
            "identifier": "IP167869",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS INSURANCE ID NUMBER",
            "identifier": "9112714",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS ID NUMBER",
            "identifier": "6100116",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN INSURANCE ID NUMBER",
            "identifier": "90051",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH INSURANCE ID NUM",
            "identifier": "158294",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH INSURANCE ID NUMBER",
            "identifier": "6189572",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS INSURANCE I",
            "identifier": "A1015113",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK INSURANCE ID N",
            "identifier": "139120",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

Verify at the official NPI Registry.