Individual provider Active NPI

William Brian Thomas, PSY.D.

  • Clinical Neuropsychologist
  • Tupelo, MS
National Provider Identifier
1720022973
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
40015 Issued in MS
Practice address
144 S Thomas St Ste 104a
Tupelo, MS 38801-5337
Phone
(662) 231-8916
Fax
(662) 259-8479
NPI assigned
Jun 16, 2006
Last updated
Jul 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 40015 MS Primary

Addresses

Primary practice location

144 S Thomas St Ste 104a
Tupelo, MS 38801-5337

Mailing address

144 S Thomas St
Ste 104a
Tupelo, MS 38801
Phone (662) 231-8916

Other identifiers 1

IdentifierTypeStateIssuer
2476081MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20040414000896 MS Practitioner - Clinical Psychologist 2365436060 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

144 S Thomas St
Suite 104a
Tupelo, MS 38801-5337
Phone (662) 231-8916

4381 S Eason Blvd
Tupelo, MS 38801-6584

830 S Gloster
North Ms Med Ctr Sleep Lab
Tupelo, MS 38801-4934
Phone (662) 377-3258

830 S Gloster St
Tupelo, MS 38801-4934

830 S Gloster St 3Rd FL E Tower
Tupelo, MS 38801-4934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center CurrentSince Oct 22, 2015 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Brian Thomas Psy D PLLC Clinical Neuropsychologist CurrentSince Jul 27, 2014 Accepting new patients
Joy Johnson Counseling PLLC PastSince Jul 27, 2014 Accepting new patients

Locations

144 S Thomas St
Ste 104A
Tupelo, MS 38801
Phone (662) 231-8916

450 E President Ave
Tupelo, MS 38801
Phone (662) 377-3204

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: williamthomas@nmhs.medalliesdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1720022973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 S THOMAS ST",
            "address_2": "STE 104A",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38801",
            "telephone_number": "662-231-8916",
            "fax_number": "662-259-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 S THOMAS ST STE 104A",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015337",
            "telephone_number": "662-231-8916",
            "fax_number": "662-259-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "WILLIAM",
        "middle_name": "BRIAN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MS",
            "license": "40015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2476081",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.