Individual provider Active NPI

Taylor Lee Thompson, PH.D

  • Psychologist
  • Jacksonville, FL
National Provider Identifier
1477826477
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY9883 Issued in FL
Practice address
6867 Southpoint Dr N
Jacksonville, FL 32216-8043
Phone
(904) 619-6071
NPI assigned
Feb 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X PY9883 FL Primary

Addresses

Primary practice location

6867 Southpoint Dr N
Jacksonville, FL 32216-8043

Mailing address

6867 Southpoint Drive North
Jacksonville, FL 32216-5433
Phone (904) 619-6071

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

LicenseStateTypeSpecialty
PY9883FLMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1477826477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6867 SOUTHPOINT DRIVE NORTH",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165433",
            "telephone_number": "904-619-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6867 SOUTHPOINT DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168043",
            "telephone_number": "904-619-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TAYLOR",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.