Carleen Thompson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R785462 Issued in MS

Practice address

1402 Miller Dr
Clarksdale, MS 38614-3427

Phone

(662) 627-8694

NPI assigned

Dec 15, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, LA2 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 2

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.

• Region VI Community Mental Health Commission

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenwood, MS
  • NPI 1154433233
  NPD
• At & TC Consultation Services, PLLC

  • Psychiatry Physician
  • Bastrop, LA
  • NPI 1699369991
  NPD
• Garden Park

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenwood, MS
  • NPI 1932437209
  NPD (past)
• Ferriday Behavioral Health System LLC

  • Psychiatric Hospital
  • Ferriday, LA
  • NPI 1679147284
  NPD (past)

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1124562871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 MILLER DR",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386143427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 MILLER DR",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386143427",
            "telephone_number": "662-627-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CARLEEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R785462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Medical Arthritis and Wellness Clinic of Mississippi Inc
• The Smile Center of Clarksdale
• Therapeutic Exprexxions Rehab, Inc.
• Kimberly Thomas, PCMHT
• Latonya R Thomas, MSW
• Malendia Hite Thornton, RPH
• Sylvester Lewis Thornton, NP
• Thrive Medical & Wellness, PLLC
• Kathleen Tinnel, C.P.N.P.
• Theresa M Tolero, PT

• All providers in Clarksdale, MS
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.