Sara Thompson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11007282 Issued in FL

Practice address

12353 Silton Peace Dr
Riverview, FL 33579-3935

Phone

(740) 601-4439

NPI assigned

Jun 4, 2020

Last updated

Jun 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593302400000",
    "number": "1871117929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12353 SILTON PEACE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335793935",
            "telephone_number": "740-601-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12353 SILTON PEACE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335793935",
            "telephone_number": "740-601-4439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 7th Ave N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337051300",
            "country_code": "US",
            "telephone_number": "727-825-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SARA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-28",
        "certification_date": "2020-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11007282",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9510243",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "431561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xakaiya D Thomas, RCSWI
• Jamaruz Thompkins, LMHC
• Deja Thompson, LCSW
• James Lee Thompson, CRNA
• Jasmine Thompson
• Thomia Thompson
• Alia Samari Thornton
• Thrive & Rise Therapy LLC
• Benjamin L Tidwell, LCSW, CCDP-DIPLOMATE
• Florence Tillman-Harris

• Psychiatric/Mental Health Nurse Practitioner in Riverview, FL
• Providers in Riverview, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2020; 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.