Active NPI
Thrishanna Clark, NP
- Psychiatric/Mental Health Nurse Practitioner
- Jackson, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 902942
- Practice address
- 3502 W Northside Dr
Jackson, MS 39213-4454 - Phone
- (601) 362-5321
- NPI assigned
- Nov 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0024177537 | VA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 902942 | MS | Primary |
Addresses
Primary practice location
3502 W Northside Dr
Jackson, MS 39213-4454
Mailing address
815 Clover Ridge Way
Brandon, MS 39047-4410
Phone (601) 665-2953
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC, CT, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 902942 | MS | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Services Board | Current | Accepting new patients | |
| Grow Healthcare Group PA | Psychiatric/Mental Health | Current | Accepting new patients |
| Vaught Christian Counseling PC | Past | Accepting new patients |
Locations
100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598
1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Farmville, VA
- NPI 1528091063
-
- Mental Health Counselor
- Miami, FL
- NPI 1245845932
CT, DC, Psychiatric/Mental Health, WA
-
- Community/Behavioral Health Agency
- Farmville, VA
- NPI 1821164583
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759363200000",
"number": "1356810360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 CLOVER RIDGE WAY",
"city": "BRANDON",
"state": "MS",
"postal_code": "390474410",
"telephone_number": "601-665-2953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3502 W NORTHSIDE DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392134454",
"telephone_number": "601-362-5321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "THRISHANNA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-19",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "VA",
"license": "0024177537",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MS",
"license": "902942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.
- 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.