Individual provider Active NPI

J. Graham Thompson, LMFT

  • Marriage & Family Therapist
  • Springfield, IL
National Provider Identifier
1609942929
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166-000115 Issued in IL
Practice address
1020 S 5TH St
Springfield, IL 62703-2312
Phone
(217) 544-3143
Fax
(217) 544-4436
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166-000115 IL Primary

Addresses

Primary practice location

1020 S 5TH St
Springfield, IL 62703-2312

Mailing address

1020 S 5TH St
Springfield, IL 62703-2312
Phone (217) 544-3143

Other identifiers 1

IdentifierTypeStateIssuer
166-000115OtherILMARRIAGE & FAMILY THERAPI

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

LicenseStateTypeSpecialty
166-000115ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Killian and Associates SC PastSince Nov 1, 1995 Accepting new patients

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239840000000",
    "number": "1609942929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 S 5TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032312",
            "telephone_number": "217-544-3143",
            "fax_number": "217-544-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S 5TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032312",
            "telephone_number": "217-544-3143",
            "fax_number": "217-544-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "J.",
        "middle_name": "GRAHAM",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2009-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166-000115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE & FAMILY THERAPI",
            "identifier": "166-000115",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.