Deidra Thompson, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R886810 Issued in MS

Practice address

3794 Highway 468 W
Pearl, MS 39208-9008

Phone

(601) 932-2880

NPI assigned

Aug 11, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, LA, PA, MN, DC, AZ, FL7 enrollments

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 7

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vitality Consultants LLCGroup PAC ID 2567942899, 3 clinicians

Forefront Telecare IncGroup PAC ID 9638319114, 29 clinicians

MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

• Graceful Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jackson, MS
  • NPI 1952106882

  Family

  Medicare reassignment NPD Authorized official
• Forefront Telecare Inc

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1174035612

  LA, MS

  Medicare reassignment Care Compare group NPD
• Vitality Consultants LLC

  • Community Health Nurse Practitioner
  • Charlotte, NC
  • NPI 1497644124

  FL, MN, PA

  Medicare reassignment Care Compare group NPD
• MDB Behavioral Health Services LLC

  dba Complete Care Rural Health Clinic

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  Medicare reassignment Care Compare group
• MD Billing, LLC

  • Psychiatry Physician
  • Jackson, MS
  • NPI 1548474042
  Medicare reassignment NPD
• Access Telecare, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1013303080

  LA, MS

  Medicare reassignment NPD
• Community Health and Dental Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Pottstown, PA
  • NPI 1295994341
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, DC, MN, MS, Psychiatric/Mental Health

  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  MS, Psychiatric/Mental Health

  Medicare reassignment NPD
• Balance Behavioral Health

  • Psychiatry Physician
  • Jackson, MS
  • NPI 1255818076
  Medicare reassignment
• Community Health and Dental Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Boyertown, PA
  • NPI 1548034663
  NPD
• MDB Care Management LLC

  • Primary Care Nurse Practitioner
  • Flowood, MS
  • NPI 1144925272
  NPD (past)

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1033585286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1783 JONES LOOP",
            "city": "TERRY",
            "state": "MS",
            "postal_code": "391709013",
            "telephone_number": "601-613-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3794 HIGHWAY 468 W",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392089008",
            "telephone_number": "601-932-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DEIDRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R886810",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R886810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Super D Drugs Acquisition Co. (Super D Drugs #139)
• Barbara L Tapps, FNP
• Tara Pharmacy SE LLC
• The Medical Foundation of Central Mississippi (Baptist Medical Clinic - Internal Medicine)
• The Pediatric Dental Studio, LLC
• Dornette Thompson, LMSW
• Kristel Heckman Thrash, LPC
• Thrive Pediatrics PLLC
• Margaret E. Tidd, M.D.
• Katerina Toal

• Psychiatric/Mental Health Nurse Practitioner in Pearl, MS
• Providers in Pearl, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.