Individual provider Active NPI

Lauren Zimmerman Thomas, PSY.D.

  • Clinical Neuropsychologist
  • Miramar, FL
National Provider Identifier
1417025719
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY8169 Issued in FL
Practice address
2900 Corporate Way
Ste D
Miramar, FL 33025-3925
Phone
(954) 276-5572
Fax
(954) 985-7049
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY8169 FL Primary
Clinical Psychologist 103TC0700X PY8169 FL
Clinical Neuropsychologist 103G00000X PSY1000616 DC
Clinical Psychologist 103TC0700X PSY1000616 DC

Addresses

Primary practice location

2900 Corporate Way
Ste D
Miramar, FL 33025-3925

Mailing address

3600 Washington St
Suite 1005
Hollywood, FL 33021-8216
Phone (954) 518-5007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220513001847 GA Practitioner - Clinical Psychologist 2365623550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shepherd Center, Inc.Group PAC ID 1052301777, 51 clinicians

Practice addresses (Care Compare)

2020 Peachtree Rd NW
Atlanta, GA 30309-1426
Phone (404) 352-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY1000616DCMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Shepherd Center Inc CurrentSince Jan 27, 2022 Accepting new patients
South Florida Psychology PA PastSince Feb 14, 2021 Accepting new patients
Dr. Michelle Channing PA Clinical PastSince May 1, 2006 Accepting new patients
Inpsych Consultants, P.a. Clinical PastSince Oct 19, 2011 Accepting new patients

Locations

2020 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 350-7333

Organizations & group practices 4

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1417025719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 WASHINGTON ST",
            "address_2": "SUITE 1005",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218216",
            "telephone_number": "954-518-5007",
            "fax_number": "954-518-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "STE D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5572",
            "fax_number": "954-985-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LAUREN",
        "middle_name": "ZIMMERMAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY8169",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8169",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "DC",
            "license": "PSY1000616",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000616",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.