Individual provider Active NPI

John Mychal Thompson, MSN, APRN, AGNP-C

  • Gerontology Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1174122121
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
212494 Issued in AR
Practice address
3002 Moores LN
Texarkana, TX 75503-2204
Phone
(430) 200-4350
Fax
(833) 491-2722
NPI assigned
Oct 21, 2020
Last updated
Jun 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 212494 AR
Gerontology Nurse Practitioner 363LG0600X 212494 AR Primary

Addresses

Primary practice location

3002 Moores LN
Texarkana, TX 75503-2204

Mailing address

1411 Terrace
Magnolia, AR 71753-2040
Phone (870) 833-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20211213001403 AR Practitioner - Nurse Practitioner 0143610832 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pallicare, IncGroup PAC ID 8123429925, 85 clinicians

Practice addresses (Care Compare)

Camden, AR 71701
Phone (972) 833-4573

1010 N Ctr St
Lonoke, AR 72086-2005
Phone (501) 438-8075

20 Wilson Farm Rd
Greenbrier, AR 72058-9310
Phone (501) 679-8970

2280 E Main St
El Dorado, AR 71730-6526
Phone (870) 895-2015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
212494ARMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Clinic Arkansas LTC LLC CurrentSince Jan 3, 2026 Accepting new patients
Access Medical Clinic Arkansas LLC CurrentSince Jun 19, 2023 Accepting new patients
Pallicare, Inc Adult Health CurrentSince Dec 26, 2024 Accepting new patients
Access Medical Clinic Arkansas LLC CurrentSince Jun 19, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Apr 27, 2022 Accepting new patients
Access Medical Clinic Arkansas LTC LLC CurrentSince Jan 3, 2026 Accepting new patients

Locations

2280 E Main St
El Dorado, AR 71730
Phone (870) 444-5216

16723 Highway 62
Garfield, AR 72732
Phone (870) 219-7706

106 N Van Buren St
Weiner, AR 72479
Phone (870) 605-0014

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: john.thompson.1@15024.direct.athenahealth.com
  • Direct secure messaging: john.thompson.1@26850.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1174122121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 TERRACE",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532040",
            "telephone_number": "870-833-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032204",
            "telephone_number": "430-200-4350",
            "fax_number": "833-491-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JOHN",
        "middle_name": "MYCHAL",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, AGNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-21",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "212494",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "212494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.