Active NPI
Thomas Powell, PH.D.
- Psychologist
- Shelburne, VT
National Provider Identifier
1841311677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 480
- Practice address
- 4281 Shelburne Rd
Shelburne, VT 05482-7121 - Phone
- (802) 985-2412
- NPI assigned
- Apr 2, 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 | 480 | VT | Primary |
Addresses
Primary practice location
4281 Shelburne Rd
Shelburne, VT 05482-7121
Mailing address
4281 Shelburne Rd
P.O. Box 807
Shelburne, VT 05482-7121
Phone (802) 985-2412
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| POWE062-8367 | Other | VT | BLUE CROSS BLUE SHIELD |
| 1003074 | Medicaid | VT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 480 | VT | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393977600000",
"number": "1841311677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4281 SHELBURNE RD",
"address_2": "P.O. BOX 807",
"city": "SHELBURNE",
"state": "VT",
"postal_code": "054827121",
"telephone_number": "802-985-2412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4281 SHELBURNE RD",
"city": "SHELBURNE",
"state": "VT",
"postal_code": "054827121",
"telephone_number": "802-985-2412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2014-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VT",
"license": "480",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "POWE062-8367",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003074",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelburne, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.