Individual provider Active NPI

Susan J Thompson, PH.D.

  • Clinical Neuropsychologist
  • Grand Forks, ND
National Provider Identifier
1396968061
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
226 Issued in ND
Practice address
3301 30TH Ave S Ste 101
Suite 100
Grand Forks, ND 58201-6009
Phone
(701) 780-9700
Fax
(701) 780-9709
NPI assigned
Apr 11, 2007
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 226 ND Primary

Addresses

Primary practice location

3301 30TH Ave S Ste 101
Suite 100
Grand Forks, ND 58201-6009

Mailing address

3301 30TH Ave S Ste 101
Suite 100
Grand Forks, ND 58201-6009
Phone (701) 780-9700

Other identifiers 2

IdentifierTypeStateIssuer
000016950MedicaidND
N715764OtherNDMEDICARE PART B

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20101206000375 ND Practitioner - Clinical Psychologist 7517154487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3301 30TH Ave S
Suite 101
Grand Forks, ND 58201-6009
Phone (701) 780-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226NDMDMetabolic Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Neuropsychology, PLLC Clinical Neuropsychologist CurrentSince Jan 1, 2011 Accepting new patients

Locations

3301 30th Ave S
Ste 101
Grand Forks, ND 58201
Phone (701) 780-9700

3374 S 31st St
Ste B
Grand Forks, ND 58201
Phone (701) 780-9700

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1396968061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 30TH AVE S STE 101",
            "address_2": "SUITE 100",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016009",
            "telephone_number": "701-780-9700",
            "fax_number": "701-780-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 30TH AVE S STE 101",
            "address_2": "SUITE 100",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016009",
            "telephone_number": "701-780-9700",
            "fax_number": "701-780-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "ND",
            "license": "226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000016950",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "N715764",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.