Individual provider Active NPI

Danielle Nicole Thompson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1932457207
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11024747 Issued in FL
Practice address
4500 140TH Ave N Ste 101
Clearwater, FL 33762-3848
Phone
(727) 371-0079
NPI assigned
Aug 17, 2012
Last updated
Apr 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11024747 FL Primary
Registered Nurse 163W00000X 9415868 FL
Licensed Practical Nurse 164W00000X 278842 NY
Licensed Practical Nurse 164W00000X LPN074839 GA

Addresses

Primary practice location

4500 140TH Ave N Ste 101
Clearwater, FL 33762-3848

Mailing address

8302 Cherry Branch Dr
Ruskin, FL 33573-0154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240625000606 FL Practitioner - Nurse Practitioner 9739622259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bywater Mental Health PLLCGroup PAC ID 7911396023, 5 clinicians

Practice addresses (Care Compare)

4500 140TH Ave N
Suite 101
Clearwater, FL 33762-3848
Phone (727) 371-0079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9415868FLMDRegistered Nurse
LPN074839GAMDLicensed Practical Nurse
278842NYMDLicensed Practical Nurse
11024747FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aim Pinellas CurrentSince Mar 9, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Bywater Mental Health PLLC CurrentSince Mar 9, 2024 Accepting new patients

Locations

4500 140th Ave N
Ste 101
Clearwater, FL 33762
Phone (727) 371-0079

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

10225 Ulmerton Rd
Ste 3A
Largo, FL 33771
Phone (727) 371-0079

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1932457207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8302 CHERRY BRANCH DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335730154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 140TH AVE N STE 101",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623848",
            "telephone_number": "727-371-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DANIELLE",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-17",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11024747",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9415868",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "278842",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN074839",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.