Stephanie Thompson, CDCA.188284

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

CDCA.188284 Issued in OH

Practice address

9 Chesapeake PLZ
Chesapeake, OH 45619-1003

Phone

(567) 588-0400

Fax

(419) 812-2377

NPI assigned

Mar 11, 2024

Last updated

Jul 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Group Home, LLC

  dba PATH Integrated Healthcare

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013
  NPD
• Phoenix Group Home, LLC

  dba Path Behavioral Health- SUD

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854
  NPD (past)

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1174381446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 GLEN HAVEN CT APT G",
            "city": "FINDLAY",
            "state": "OH",
            "postal_code": "458408158",
            "telephone_number": "567-245-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CHESAPEAKE PLZ",
            "city": "CHESAPEAKE",
            "state": "OH",
            "postal_code": "456191003",
            "telephone_number": "567-588-0400",
            "fax_number": "419-812-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "STEPHANIE",
        "credential": "CDCA.188284",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.188284",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "CDCA.188284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174381446",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Tackett
• Joshua Taylor
• Sally Gail Taylor
• Jerry Edward Thomas, LICDC-CS
• Triffawna R Thomas, LPN
• Jody G Thornburg
• Ciji Thornton
• Jeffrey Tipton, CDCA
• James A Traylor
• Jenny Truman

• Case Manager/Care Coordinator in Chesapeake, OH
• Providers in Chesapeake, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.