Active NPI
Thomas Barnes Virden III, PH.D.
- Psychologist
- Glendale, AZ
National Provider Identifier
1801079603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3886
- Practice address
- 19389 N 59TH Ave
Glendale, AZ 85308-6500 - Phone
- (623) 537-6000
- Fax
- (623) 537-6014
- NPI assigned
- Dec 14, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3886 | AZ | Primary |
Addresses
Primary practice location
19389 N 59TH Ave
Glendale, AZ 85308-6500
Mailing address
19555 N 59TH Ave
Glendale, AZ 85308-6813
Phone (623) 537-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 311757 | Medicaid | AZ |
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 |
|---|---|---|---|
| 3886 | AZ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1801079603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19555 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086813",
"telephone_number": "623-537-6000",
"fax_number": "623-537-6014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19389 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086500",
"telephone_number": "623-537-6000",
"fax_number": "623-537-6014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIRDEN",
"first_name": "THOMAS",
"middle_name": "BARNES",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-14",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "3886",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "311757",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
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- Mika Visentin, SLPA
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- Vital Health and Wellness Clinic
- Vital Hospice Care, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.