Individual provider Active NPI

Michael Bryant Thompson, M.D.

  • Psychiatry Physician
  • Louisville, KY
National Provider Identifier
1457490849
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
42505 Issued in KY
Practice address
4201 Springhurst Blvd
Suite 203
Louisville, KY 40241-6155
Phone
(502) 425-6690
Fax
(502) 425-6629
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 42505 KY Primary

Addresses

Primary practice location

4201 Springhurst Blvd
Suite 203
Louisville, KY 40241-6155

Mailing address

1321 13TH St N
Suite 203
Saint Cloud, MN 56303-2613
Phone (502) 425-6690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MN2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150828002346 OH Practitioner - Psychiatry 6901955210 Reassigns benefits to 1 organization
I20160610000740 MN Practitioner - Psychiatry 6901955210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Kentucky College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1321 13TH St N
Saint Cloud, MN 56303-2613
Phone (320) 252-5010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42505KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Minnesota Mental Health Center Current Accepting new patients
Central Minnesota Mental Health Center CurrentSince Jan 1, 2016 Accepting new patients
Zepf Center Psychiatry CurrentSince Jul 5, 2015 Accepting new patients
Central Minnesota Mental Health Center CurrentSince Jan 1, 2016 Accepting new patients
Zepf Center CurrentSince Jul 5, 2015 Accepting new patients
Vitality Unlimited PastSince Jan 1, 2024 Accepting new patients

Locations

308 12th Ave S
Buffalo, MN 55313
Phone (763) 682-4400

1321 13th St N
Ste 203
Saint Cloud, MN 56303

1321 13th St N
Saint Cloud, MN 56303
Phone (320) 252-5010

411 3rd St N
Waite Park, MN 56387
Phone (320) 202-2037

6605 W Central Ave
Ste 100
Toledo, OH 43617
Phone 41984177012235

905 Nebraska Ave
Toledo, OH 43607
Phone (419) 244-8848

6605 W Central Ave
Toledo, OH 43617
Phone (419) 255-4050

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1457490849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 13TH ST N",
            "address_2": "SUITE 203",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032613",
            "telephone_number": "502-425-6690",
            "fax_number": "502-425-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SPRINGHURST BLVD",
            "address_2": "SUITE 203",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402416155",
            "telephone_number": "502-425-6690",
            "fax_number": "502-425-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MICHAEL",
        "middle_name": "BRYANT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "42505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.