Individual provider Active NPI

Julia E Thompson, PHD

  • Psychologist
  • Johnson City, TN
National Provider Identifier
1457789323
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3265 Issued in TN
Practice address
2 Professional Park Dr Ste 21
Johnson City, TN 37604-6584
Phone
(423) 379-8120
NPI assigned
Oct 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3265 TN Primary

Addresses

Primary practice location

2 Professional Park Dr Ste 21
Johnson City, TN 37604-6584

Mailing address

PO Box 699
Mountain Home, TN 37684-0699

Other identifiers 1

IdentifierTypeStateIssuer
Q081630MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230419003210 TN Practitioner - Clinical Psychologist 5597079954 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation CurrentSince Mar 15, 2023 Accepting new patients

Locations

2 Professional Park Dr
Ste 21
Johnson City, TN 37604
Phone (423) 379-8082

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1457789323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PROFESSIONAL PARK DR STE 21",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046584",
            "telephone_number": "423-379-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JULIA",
        "middle_name": "E",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-31",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "3265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q081630",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.