Bianca Bullie-Thompson, FNP-C, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2022153286 Issued in MS

Practice address

1500 E Woodrow Wilson
Jackson, MS 39216

Phone

(601) 362-4471

Fax

(601) 368-4089

NPI assigned

Nov 24, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Renewed Hope Wellness Clinic LLC

  • Adult Mental Health Clinic/Center
  • Pearl, MS
  • NPI 1639973720

  Single Specialty

  Medicare reassignment NPD Authorized official
• Community Mental Health Clinic, LLC

  • Adult Mental Health Clinic/Center
  • Pearl, MS
  • NPI 1871358184

  Single Specialty

  NPD

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

{
    "created_epoch": "1322092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1083981757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-362-4471",
            "fax_number": "601-368-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-362-4471",
            "fax_number": "601-368-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLIE-THOMPSON",
        "first_name": "BIANCA",
        "credential": "FNP-C, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-24",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "867841",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "2022153286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMHNP - ANCC",
            "identifier": "2022153286",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL NURSE PRACTITIONER LICENSE",
            "identifier": "F1111175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS BOARD OF NURSING LICENSE NUMBER",
            "identifier": "RN867841",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Parker Buford, M.D.
• Ashley Lynn Buice, M.D.
• Hannah Buie
• Building Futures, LLC
• Charla Renee Bullard, ATR-BC, LPAT
• Christopher Bullin, O.D.
• Scott Bulloch
• Anna Lee Bullock
• Brittany Bullock, MS,CAT
• Sonja P Bullock, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Jackson, MS
• Providers in Jackson, 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 Jun 4, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.