Active NPI
Kelly Ann Thomas, PHD
- Health Service Psychologist
- Bloomington, IN
National Provider Identifier
1437442928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- License
- 20042882A
- Practice address
- 4935 W Arlington Rd
Bloomington, IN 47404-1187 - Phone
- (812) 353-3800
- Fax
- (812) 353-3770
- NPI assigned
- May 17, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | 20042882A | IN | Primary |
Addresses
Primary practice location
4935 W Arlington Rd
Bloomington, IN 47404-1187
Mailing address
PO Box 1329
Bloomington, IN 47402-1329
Phone (812) 353-3087
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20042882A | IN | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438819200000",
"number": "1437442928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1329",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474021329",
"telephone_number": "812-353-3087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4935 W ARLINGTON RD",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474041187",
"telephone_number": "812-353-3800",
"fax_number": "812-353-3770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "KELLY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-17",
"last_updated": "2015-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "IN",
"license": "20042882A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.