Thomas Lee Ippel, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301003264 Issued in MI

Practice address

2020 Raybrook St SE
Suite 203
Grand Rapids, MI 49546-7717

Phone

(616) 942-9942

NPI assigned

Feb 1, 2007

Last updated

Jun 15, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Life Guidance Services

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  • NPI 1336185032
  NPD (past)
• Project Rehab

  • Substance Abuse Rehabilitation Facility
  • Grand Rapids, MI
  • NPI 1104986603
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1447397831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 RAYBROOK ST SE",
            "address_2": "SUITE 203",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467717",
            "telephone_number": "616-942-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 RAYBROOK ST SE",
            "address_2": "SUITE 203",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467717",
            "telephone_number": "616-942-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPPEL",
        "first_name": "THOMAS",
        "middle_name": "LEE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301003264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF MICHIGAN PIN",
            "identifier": "68OD145630",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine of West Michigan PLLC
• Internal Medicine Outpatient Services, PC
• Intervention Insights Inc.
• Kristin Ippel, RN
• Steven Peter Ippel, CRNA
• Maham Iqbal, MD
• Alexa Ireland, M.S. CCC-SLP
• Fiza Irfan, LMSW
• Chelsea Leentje Irish
• Lyanette Irizarry, MD

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.