Fatimah Thiam

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1076154 Issued in TX

Practice address

4102 W Adams Ave
Temple, TX 76504-8551

Phone

(254) 350-0967

NPI assigned

Jun 28, 2019

Last updated

Jan 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OH, CO3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Border Region MH Mr Community CenterGroup PAC ID 0648207381, 19 clinicians

Heart of Texas Region MHMR CenterGroup PAC ID 9830105105, 26 clinicians

Burke CenterGroup PAC ID 1254312077, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Border Region MH Mr Community Center

  • Psychiatry Physician
  • Laredo, TX
  • NPI 1124060173
  Medicare reassignment Care Compare group NPD
• Burke Center

  • Psychiatry Physician
  • Lufkin, TX
  • NPI 1396792420
  Medicare reassignment Care Compare group NPD
• Heart of Texas Region MHMR Center

  dba Heart of Texas Behavioral Health Network

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waco, TX
  • NPI 1639399132
  Medicare reassignment Care Compare group NPD
• Bexar County Board of Trustees for Mental Health Mental Retardation

  dba The Center for Health Care Services

  • Counselor
  • San Antonio, TX
  • NPI 1730134586
  Medicare reassignment NPD
• Texana Center

  • Multi-Specialty Clinic/Center
  • Rosenberg, TX
  • NPI 1912954058
  Medicare reassignment NPD
• The Gulf Coast Center

  • Psychiatry Physician
  • League City, TX
  • NPI 1245285899
  Medicare reassignment NPD
• TP-Health Incorporated

  dba Online Telemedicine

  • Psychiatry Physician
  • Missouri City, TX
  • NPI 1760047526

  OH

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  CO, OH, Psychiatric/Mental Health, TX

  Medicare reassignment NPD
• Central Behavioral Clinic LLC

  dba Central Behavioral Clinic

  • Psychiatric/Mental Health Nurse Practitioner
  • Temple, TX
  • NPI 1013691351
  NPD Authorized official
• Burke Center

  • Developmental Disabilities Clinic/Center
  • Lufkin, TX
  • NPI 1164572772
  NPD (past)

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1669033791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 W ADAMS AVE",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765048551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 W ADAMS AVE",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765048551",
            "telephone_number": "254-350-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIAM",
        "first_name": "FATIMAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "70333",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0004642-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1076154",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "925924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacy Michelle Theobald, LCSW
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• Therapy Lincs
• Therapyseat, PLLC
• Therapyseat, PLLC
• Kimberly F Thiele, P. T. A.
• Chad Thielepape
• Prem Kumar Thirunagari, MD
• Thomas E Martens DO PA (Federal Comp and Wellness)
• Ashley Thomas, D.O.

• Psychiatric/Mental Health Nurse Practitioner in Temple, TX
• Providers in Temple, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.