Organization Active NPI

Center for Child and Adult Psychiatry LLC

  • Child & Adolescent Psychiatry Physician
  • Tampa, FL
National Provider Identifier
1861950420
Registry record updated Mar 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
CENTER FOR CHILD AND ADULT PSYCHIATRY LLC
Practice address
2909 W Bay to Bay Blvd Ste 210
Tampa, FL 33629-8100
Phone
(813) 995-1775
NPI assigned
Mar 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2019

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

Authorized official

Name
Gregory Thorkelson, MD
Title
President
Phone
(330) 632-0172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

2909 W Bay to Bay Blvd Ste 210
Tampa, FL 33629-8100

Mailing address

1911 Monongahela Ave Unit 82661
Pittsburgh, PA 15218-6616
Phone (330) 632-0173

Other identifiers 1

IdentifierTypeStateIssuer
1295225597OtherNATIONAL PLAN & PROVIDER ENUMERATION SYSTEM

National Provider Directory

National Provider Directory

Locations

2909 W Bay To Bay Blvd
Ste 210
Tampa, FL 33629
Phone (813) 732-9579

1911 Monongahela Ave
Unit 82661
Pittsburgh, PA 15218

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551571200000",
    "number": "1861950420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 MONONGAHELA AVE UNIT 82661",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152186616",
            "telephone_number": "330-632-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 W BAY TO BAY BLVD STE 210",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336298100",
            "telephone_number": "813-995-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR CHILD AND ADULT PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-03",
        "last_updated": "2019-03-03",
        "status": "A",
        "authorized_official_last_name": "THORKELSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-632-0172",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PLAN & PROVIDER ENUMERATION SYSTEM",
            "identifier": "1295225597",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2019; 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.