Active NPI
Terry Lee Thompson III, MA, BCBA
- Behavior Analyst
- Greenwood, IN
National Provider Identifier
1124547963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-17-26156
- Practice address
- 21 S Park Blvd Ste 21
Greenwood, IN 46143 - Phone
- (317) 449-2104
- Fax
- (317) 520-8200
- NPI assigned
- Sep 13, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-17-26156 | Primary |
Addresses
Primary practice location
21 S Park Blvd Ste 21
Greenwood, IN 46143
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
Other practice location 1
6067 Decatur Blvd
Indianapolis, IN 46241
Phone (317) 856-5201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-17-26156 | Other | BCBA CERTIFICATE |
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)
- Not enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adaptive Community Support Services Inc | Behavior Analyst | Past | Accepting new patients |
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.
-
- Developmentally Disabled Services Day Training Agency
- New Albany, IN
- NPI 1770970576
Behavior Analyst
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": "1546905600000",
"number": "1124547963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 DEPAUW BLVD STE 3070",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462686135",
"telephone_number": "855-324-0885",
"fax_number": "317-520-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 S PARK BLVD STE 21",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "46143",
"telephone_number": "317-449-2104",
"fax_number": "317-520-8200"
}
],
"practiceLocations": [
{
"address_1": "6067 Decatur Blvd",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "46241",
"country_code": "US",
"telephone_number": "317-856-5201",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMPSON",
"first_name": "TERRY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "MA, BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-13",
"last_updated": "2019-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-17-26156",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA CERTIFICATE",
"identifier": "1-17-26156",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.