NPIMap

Organization Active NPI

Thrive Behavioral Health Services

Doing business as Thrive BHS

  • Psychiatric/Mental Health Nurse Practitioner
  • St Louis Park, MN
National Provider Identifier
1518710128
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
THRIVE BEHAVIORAL HEALTH SERVICES
Doing business as
Thrive BHS
Practice address
1650 W End Blvd Ste 100
St Louis Park, MN 55416-5369
Phone
(612) 477-5139
Fax
(813) 441-8534
NPI assigned
Apr 11, 2024
Last updated
Apr 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Authorized official

Name
Esther Mugomba-BirdNPI 1639504400
Title
Owner
Phone
(813) 498-9378

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

1650 W End Blvd Ste 100
St Louis Park, MN 55416-5369

Mailing address

1650 W End Blvd Ste 100
St Louis Park, MN 55416-5369
Phone (612) 477-5139

Other names 1

  • Thrive BHS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240424000356 MN Part B Supplier - Clinic/Group Practice 8820450893 Receives reassigned benefits from 1 practitioner
Practice locations: St Louis Park, MN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Thrive Behavioral Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1518710128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 W END BLVD STE 100",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165369",
            "telephone_number": "612-477-5139",
            "fax_number": "813-441-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W END BLVD STE 100",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165369",
            "telephone_number": "612-477-5139",
            "fax_number": "813-441-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "MUGOMBA-BIRD",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-498-9378"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thrive BHS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.