Individual provider Active NPI

Brian Keith Thomson, PH.D.

  • Psychologist
  • Syracuse, NY
National Provider Identifier
1811249527
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
009939 Issued in NY
Practice address
620 Madison St
Syracuse, NY 13210-2319
Phone
(315) 426-7726
NPI assigned
Oct 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 009939 NY Primary

Addresses

Primary practice location

620 Madison St
Syracuse, NY 13210-2319

Mailing address

620 Madison St
Syracuse, NY 13210-2319
Phone (315) 426-7726

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
009939NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1811249527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MADISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102319",
            "telephone_number": "315-426-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MADISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102319",
            "telephone_number": "315-426-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.