Individual provider Active NPI

Candace Marie Thompson, M.D.

  • Psychiatry Physician
  • Memphis, TN
National Provider Identifier
1376633594
Registry record updated Jan 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
46434 Issued in TN
Practice address
1247 Carr Ave
Memphis, TN 38104-2610
Phone
(866) 901-3621
Fax
(662) 673-3910
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 22335 MS
Psychiatry Physician 2084P0800X 46434 TN Primary

Addresses

Primary practice location

1247 Carr Ave
Memphis, TN 38104-2610

Mailing address

1247 Carr Ave
Memphis, TN 38104-4544
Phone (866) 901-3621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 29, 2026 through May 29, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22335MSMDPsychiatry Physician
46434TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Tennessee CurrentSince Jan 2, 2013 Accepting new patients
State of Tennessee State F & a Payroll CurrentSince Jan 2, 2013 Accepting new patients
Vibrant Health Choice, PLLC Psychiatry CurrentSince Dec 13, 2020 Accepting new patients
State of Tennessee Current Accepting new patients
Bear Hill Healthcare LLC Past Accepting new patients
Alliance Healthcare Services Past Accepting new patients

Locations

8829 Centre St
Southaven, MS 38671
Phone (662) 280-5758

951 Court Ave
Memphis, TN 38103
Phone (901) 577-1800

500 Deaderick St
Bldg 6TH
Nashville, TN 37242

Organizations & group practices 6

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612051200000",
    "number": "1376633594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 CARR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381044544",
            "telephone_number": "866-901-3621",
            "fax_number": "662-673-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 CARR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042610",
            "telephone_number": "866-901-3621",
            "fax_number": "662-673-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CANDACE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-01-31",
        "certification_date": "2021-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "22335",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "46434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.