Active NPI
Anthony Alan Thomalla, PH.D.
- Psychologist
- Richmond, IN
National Provider Identifier
1790887669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20040651A
- Practice address
- 1915 S G St
Ste 2
Richmond, IN 47374-6511 - Phone
- (307) 349-6080
- NPI assigned
- Sep 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP5573 | MN | |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 20040651A | IN | |
| Clinical Psychologist | 103TC0700X | 20040651A | IN | |
| Counseling Psychologist | 103TC1900X | 20040651A | IN | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 20040651A | IN | |
| Forensic Psychologist | 103TF0200X | 20040651A | IN | |
| Health Service Psychologist | 103TH0100X | 20040651A | IN | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 20040651A | IN | |
| Group Psychotherapy Psychologist | 103TP2701X | 20040651A | IN | |
| Rehabilitation Psychologist | 103TR0400X | 20040651A | IN | |
| Psychologist | 103T00000X | 20040651A | IN | Primary |
Addresses
Primary practice location
1915 S G St
Ste 2
Richmond, IN 47374-6511
Mailing address
1915 S G St
Ste 2
Richmond, IN 47374-6511
Phone (765) 960-0942
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100092720B | Medicaid | IN | |
| P00396776 | Other | IN | RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20040651A | IN | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751328000000",
"number": "1790887669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1915 S G ST",
"address_2": "STE 2",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473746511",
"telephone_number": "765-960-0942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 S G ST",
"address_2": "STE 2",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473746511",
"telephone_number": "307-349-6080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMALLA",
"first_name": "ANTHONY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2025-07-01",
"certification_date": "2025-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP5573",
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "20040651A",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20040651A",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "IN",
"license": "20040651A",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "IN",
"license": "20040651A",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "IN",
"license": "20040651A",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "IN",
"license": "20040651A",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "IN",
"license": "20040651A",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "IN",
"license": "20040651A",
"primary": false
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "IN",
"license": "20040651A",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20040651A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100092720B",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00396776",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.