Active NPI
Thomas Ward Bishop, PSY D
- Clinical Psychologist
- Chelsea, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301017038
- Practice address
- 14700 East Old US 12
Chelsea, MI 48118-1185 - Phone
- (734) 475-1321
- NPI assigned
- Jul 12, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P2573 | TN | |
| Family Psychologist | 103TF0000X | 6301017038 | MI | |
| Clinical Psychologist | 103TC0700X | 6301017038 | MI | Primary |
Addresses
Primary practice location
14700 East Old US 12
Chelsea, MI 48118-1185
Mailing address
3621 South State Street
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3980983 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1100 E 3Rd St
Chattanooga, TN 37403-2241
Phone (423) 778-8837
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2573 | TN | MD | Professional Counselor |
| P2573 | TN | MD | Clinical Psychologist |
| 1058 | KS | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Erlanger Health | Current | Accepting new patients | |
| Medical Education Assistance Corporation | Current | Accepting new patients | |
| Erlanger Health | Current | Accepting new patients | |
| Prairie View, Inc. | Past | Accepting new patients | |
| Prairie View, Inc. | Past | Accepting new patients |
Locations
1100 E 3rd St
Chattanooga, TN 37403
Phone (423) 778-2957
222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200
2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434
6350 W Andrew Johnson Hwy
Talbott, TN 37877
Phone (423) 586-5031
6350 W Andrew Johnson Hwy
#100
Talbott, TN 37877
Phone (423) 586-5031
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Chattanooga, TN
- NPI 1477256303
-
dba ETSU Physicians and Associates
- Internal Medicine Physician
- Johnson City, TN
- NPI 1235180480
-
- Psychologist
- Ann Arbor, MI
- NPI 1568487130
-
- Durable Medical Equipment & Medical Supplies
- Chattanooga, TN
- NPI 1740073329
-
- Psychiatry Physician
- Newton, KS
- NPI 1558426486
-
- Psychiatric Hospital
- Wichita, KS
- NPI 1902251655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496966400000",
"number": "1760480966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 SOUTH STATE STREET",
"address_2": "700 KMS PLACE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-936-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14700 EAST OLD US 12",
"city": "CHELSEA",
"state": "MI",
"postal_code": "481181185",
"telephone_number": "734-475-1321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISHOP",
"first_name": "THOMAS",
"middle_name": "WARD",
"credential": "PSY D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-12",
"last_updated": "2017-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P2573",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "MI",
"license": "6301017038",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301017038",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3980983",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chelsea, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; 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.