Individual provider Active NPI

David Mark Thomas, LPC

  • Professional Counselor
  • Murfreesboro, TN
National Provider Identifier
1164463766
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC1910 Issued in TN
Practice address
545 Brandies Cir
Murfreesboro, TN 37128
Phone
(615) 295-2176
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 169249 KY
Professional Counselor 101YP2500X LPC1910 TN Primary

Addresses

Primary practice location

545 Brandies Cir
Murfreesboro, TN 37128

Mailing address

301 S Perimeter Park Dr Ste 210
Nashville, TN 37211-4128
Phone (615) 726-3603

Other practice location 1

1169 Eastern Pkwy Ste 1226
Louisville, KY 40217-1462
Phone (502) 822-7679

Other practice location 2

545 Brandies Cir
Murfreesboro, TN 37128
Phone (615) 295-2176

Other identifiers 2

IdentifierTypeStateIssuer
7100443270MedicaidKY
5441170MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240122003211 TN Practitioner - Mental Health Counselor 2567814965 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
169249KYMDProfessional Counselor
LPC1910TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Voices for Children CurrentSince Jan 1, 2024 Accepting new patients

Locations

500 Professional Park Dr
Goodlettsvlle, TN 37072
Phone (615) 269-7751

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/tnvoices/r4/

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1164463766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S PERIMETER PARK DR STE 210",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372114128",
            "telephone_number": "615-726-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BRANDIES CIR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37128",
            "telephone_number": "615-295-2176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1169 Eastern Pkwy Ste 1226",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402171462",
            "country_code": "US",
            "telephone_number": "502-822-7679",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "545 Brandies Cir",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "37128",
            "country_code": "US",
            "telephone_number": "615-295-2176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "169249",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "LPC1910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100443270",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5441170",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.