Individual provider Active NPI

David G Thompson, PSYD., LP

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1649481870
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4807 Issued in MN
Practice address
3813 Garfield Ave
Minneapolis, MN 55409-1116
Phone
(612) 807-0388
NPI assigned
May 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP4807 MN Primary

Addresses

Primary practice location

3813 Garfield Ave
Minneapolis, MN 55409-1116

Mailing address

3813 Garfield Ave
Minneapolis, MN 55409-1116
Phone (612) 807-0388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090825000320 MN Practitioner - Clinical Psychologist 1254485345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3808 Grand Ave S
Minneapolis, MN 55409-1233
Phone (612) 807-0388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP4807MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integral Psychotherapy, LLC Clinical CurrentSince Jun 30, 2009 Accepting new patients
Kingfield Psychotherapy Current Accepting new patients

Locations

3808 Grand Ave S
Minneapolis, MN 55409
Phone (612) 237-6311

Organizations & group practices 2

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": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649481870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3813 GARFIELD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091116",
            "telephone_number": "612-807-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3813 GARFIELD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091116",
            "telephone_number": "612-807-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DAVID",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PSYD., LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.