Organization Active NPI

Thrive Psychiatry Inc.

  • Psychiatry Physician
  • Eau Claire, WI
National Provider Identifier
1922726892
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
THRIVE PSYCHIATRY INC.
Practice address
312 S Barstow St
Eau Claire, WI 54701-2881
Phone
(816) 810-9841
NPI assigned
Aug 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Brenda KibolaNPI 1821415795
Title
Owner
Phone
(816) 810-9841

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

312 S Barstow St
Eau Claire, WI 54701-2881

Mailing address

PO Box 473
Rice Lake, WI 54868-0473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240416000441 WI Part B Supplier - Clinic/Group Practice 1850730433 Receives reassigned benefits from 2 practitioners
Practice locations: Eau Claire, WI; Rice Lake, WI

National Provider Directory

National Provider Directory

Locations

2004 Highland Ave
Ste 2B
Eau Claire, WI 54701
Phone (715) 317-5466

312 S Barstow St
Eau Claire, WI 54701
Phone (816) 810-9841

138 N Main St
Ste 200
Rice Lake, WI 54868
Phone (715) 317-5466

Practitioners & affiliated clinicians

Practitioners 4

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": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1922726892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 473",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548680473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S BARSTOW ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012881",
            "telephone_number": "816-810-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE PSYCHIATRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "KIBOLA",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-810-9841"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.