NPIMap

Organization Active NPI

Thomas B. Dudgeon, PH.D., PC

  • Psychologist
  • Rockford, IL
National Provider Identifier
1528243086
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
THOMAS B. DUDGEON, PH.D., PC
Practice address
6066 Strathmoor Dr
Suite 3C
Rockford, IL 61107-6633
Phone
(815) 399-9303
Fax
(815) 399-9306
NPI assigned
Jan 3, 2008
Last updated
Jan 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Authorized official

Name
Dr. Thomas B. Dudgeon, PH.D.NPI 1184752602
Title
Clinical Psychologist
Phone
(815) 399-9303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X IL Primary

Addresses

Primary practice location

6066 Strathmoor Dr
Suite 3C
Rockford, IL 61107-6633

Mailing address

6066 Strathmoor Dr
Suite 3C
Rockford, IL 61107-6633
Phone (815) 399-9303

National Provider Directory

National Provider Directory

Locations

6066 Strathmoor Dr
Ste 3C
Rockford, IL 61107
Phone (815) 227-4533

Practitioners & affiliated clinicians

Practitioners 2

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": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1528243086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6066 STRATHMOOR DR",
            "address_2": "SUITE 3C",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076633",
            "telephone_number": "815-399-9303",
            "fax_number": "815-399-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6066 STRATHMOOR DR",
            "address_2": "SUITE 3C",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076633",
            "telephone_number": "815-399-9303",
            "fax_number": "815-399-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS B. DUDGEON, PH.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "DUDGEON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "815-399-9303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.