Individual provider Active NPI

Ryan Thomas Thorson, PHD

  • Clinical Psychologist
  • Omaha, NE
National Provider Identifier
1225326705
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8685 Issued in NE
Practice address
444 S 44TH St
Omaha, NE 68131-3727
Phone
(402) 559-6408
Fax
(402) 559-5737
NPI assigned
Jul 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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 8685 NE Primary

Addresses

Primary practice location

444 S 44TH St
Omaha, NE 68131-3727

Mailing address

985450 Nebraska Medical Ctr
Omaha, NE 68198-5450
Phone (402) 559-6408

Other identifiers 1

IdentifierTypeStateIssuer
10025287200MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20160201000322 MN Practitioner - Clinical Psychologist 0042451635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Independent Management Services of MN, Inc.Group PAC ID 1658674775, 9 clinicians

Practice addresses (Care Compare)

101 21St St SE
Suite 1
Austin, MN 55912-4322
Phone (507) 437-6389

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8685NEMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Management Services of MN, Inc. CurrentSince Dec 23, 2015 Accepting new patients

Locations

709 Algon St
Albert Lea, MN 56007
Phone (507) 396-4477

109 11th Ave NE
#C
Austin, MN 55912

101 21st St SE
Ste 1
Austin, MN 55912
Phone (507) 437-6389

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": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1225326705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985450",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S 44TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681313727",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSON",
        "first_name": "RYAN",
        "middle_name": "THOMAS",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-18",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "8685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025287200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.