Individual provider Active NPI

Robert Edgar Thompson, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1265647648
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
773 Issued in KY
Practice address
3044 Breckenridge LN
Suite 204
Louisville, KY 40220-2192
Phone
(502) 493-8002
NPI assigned
May 11, 2007
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 773 KY Primary

Addresses

Primary practice location

3044 Breckenridge LN
Suite 204
Louisville, KY 40220-2192

Mailing address

309 11TH St
Carrollton, KY 41008-1435
Phone (502) 732-6420

Other practice location 1

309 11th St
Carrollton, KY 41008-1435
Phone (502) 732-6420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210617001393 KY Practitioner - Clinical Social Worker 8426458480 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1265647648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 11TH ST",
            "city": "CARROLLTON",
            "state": "KY",
            "postal_code": "410081435",
            "telephone_number": "502-732-6420",
            "fax_number": "502-732-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 BRECKENRIDGE LN",
            "address_2": "SUITE 204",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402202192",
            "telephone_number": "502-493-8002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 11th St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "KY",
            "postal_code": "410081435",
            "country_code": "US",
            "telephone_number": "502-732-6420",
            "fax_number": "502-732-6424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ROBERT",
        "middle_name": "EDGAR",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.