Individual provider Active NPI

Louisa Isoud Thompson, PH.D.

  • Clinical Neuropsychologist
  • Providence, RI
National Provider Identifier
1770130692
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS01764 Issued in RI
Practice address
345 Blackstone Blvd Ste 2
Providence, RI 02906-4829
Phone
(401) 444-6043
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 PS01764 RI Primary

Addresses

Primary practice location

345 Blackstone Blvd Ste 2
Providence, RI 02906-4829

Mailing address

345 Blackstone Blvd
Providence, RI 02906-4800
Phone (401) 455-6403

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LOThompson@Kentri.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20190927001336 RI Practitioner - Clinical Psychologist 9436489820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS01764RIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Clinical Neuropsychologist CurrentSince Oct 1, 2019 Accepting new patients
Affinity Physicians LLC CurrentSince Oct 1, 2019 Accepting new patients

Locations

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

345 Blackstone Blvd
Ste 2
Providence, RI 02906
Phone (401) 455-6219

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

171 Service Ave
Fl 2
Warwick, RI 02886
Phone (401) 430-0985

Interoperability endpoints

  • Direct secure messaging: lothompson@direct.carene.org
  • Direct secure messaging: lothompson@kentri.org

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": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1770130692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064800",
            "telephone_number": "401-455-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD STE 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064829",
            "telephone_number": "401-444-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LOUISA",
        "middle_name": "ISOUD",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "RI",
            "license": "PS01764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LOThompson@Kentri.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "345 Blackstone Blvd Ste 2",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029064829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.