Active NPI
Erik Converse Thompson, MA
- Clinical Psychologist
- Burlington, VT
National Provider Identifier
1811926439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 047 0000 619
- Practice address
- 1 Mill St
Box B10
Burlington, VT 05401-1530 - Phone
- (802) 658-4800
- NPI assigned
- Jul 3, 2006
- Last updated
- Feb 13, 2008
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 047 0000 619 | VT | Primary |
Addresses
Primary practice location
1 Mill St
Box B10
Burlington, VT 05401-1530
Mailing address
1 Mill St
Box B10
Burlington, VT 05401-1530
Phone (802) 658-4800
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 078188 | Other | VT | OPTIONS |
| 11467960 | Other | VT | CAQH |
| 41501 | Other | VT | MVP |
| 2904620 | Other | VT | CIGNA BH |
| OVN1286 | Medicaid | VT | |
| 28619 | Other | VT | BLUE CROSS/BLUE SHIELD |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047 0000 619 | VT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202860800000",
"number": "1811926439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MILL ST",
"address_2": "BOX B10",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011530",
"telephone_number": "802-658-4800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MILL ST",
"address_2": "BOX B10",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011530",
"telephone_number": "802-658-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "ERIK",
"middle_name": "CONVERSE",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2008-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "047 0000 619",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIONS",
"identifier": "078188",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11467960",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "41501",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BH",
"identifier": "2904620",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OVN1286",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "28619",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.