Active NPI
Jamal Eugene Thomas
- Adult Development & Aging Psychologist
- Washington, DC
National Provider Identifier
1568037166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Development & Aging Psychologist
- License
- 3075399
- Practice address
- 1417 Saratoga Ave NE
Washington, DC 20018-1923 - Phone
- (202) 531-5541
- NPI assigned
- May 25, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | 3075399 | DC | Primary |
Addresses
Primary practice location
1417 Saratoga Ave NE
Washington, DC 20018-1923
Mailing address
65 Galveston St SW
Washington, DC 20032-1954
Phone (202) 531-5541
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70199323 | Medicaid | DC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3075399 | DC | MD | Adult Development & Aging Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1568037166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 GALVESTON ST SW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200321954",
"telephone_number": "202-531-5541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1417 SARATOGA AVE NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200181923",
"telephone_number": "202-531-5541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "JAMAL",
"middle_name": "EUGENE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-25",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "DC",
"license": "3075399",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "70199323",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.