Jacqueline Jones Thompson, PMHNP

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

5012379 Issued in NC

Practice address

5306 NC Highway 55 Ste 105
Durham, NC 27713-7812

Phone

(919) 457-1517

Fax

(919) 363-7697

NPI assigned

Oct 7, 2019

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

Other identifiers 1

Other names 1

• Jacqueline Leeann Thompson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rapha Healthcare Services LLCGroup PAC ID 5294025524, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jthompson500366@direct.conehealth.com

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.

• Pathos P Consultng LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Greensboro, NC
  • NPI 1629831060
  Medicare reassignment NPD Authorized official
• Rapha Healthcare Services,LLC

  • Multi-Specialty Clinic/Center
  • Durham, NC
  • NPI 1316335128
  Medicare reassignment Care Compare group NPD
• Alamance Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Burlington, NC
  • NPI 1326010273
  Medicare reassignment NPD
• Senior Health and Education Partners PLLC

  • Psychiatry Physician
  • Durham, NC
  • NPI 1205237245
  Medicare reassignment NPD
• Alamance Regional Medical Center, Inc

  • Pharmacy
  • Burlington, NC
  • NPI 1851681993
  NPD
• Cornerstone Medical Center, PA

  • Family Medicine Physician
  • Burlington, NC
  • NPI 1548233182
  NPD

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1356982797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 BELLFARE DR",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275297366",
            "telephone_number": "919-418-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 NC HIGHWAY 55 STE 105",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137812",
            "telephone_number": "919-457-1517",
            "fax_number": "919-363-7697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Bellfare Dr",
            "address_purpose": "LOCATION",
            "city": "Garner",
            "state": "NC",
            "postal_code": "275297366",
            "country_code": "US",
            "telephone_number": "919-418-1246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JACQUELINE",
        "middle_name": "JONES",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5012379",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5012379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHIATRIC NURSE PRACTITIONER",
            "identifier": "5012379",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Garner",
            "affiliation": "N",
            "address_1": "131 Bellfare Dr",
            "city": "Garner",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275297366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "THOMPSON",
            "middle_name": "LEEANN",
            "credential": "PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clifton Earl Thompson Jr., PMHNP
• Danielle Theresa Thompson
• Elizabeth Jaclyn Thompson, M.D.
• Ellecia Marie Thompson, MSW,LCSW
• Erin Michelle Thompson, SLP
• James Cecil Thompson, DDSPA
• Jasmine Thompson
• Jillian Thompson, MT-BC
• John P Thompson, M.D.
• Kiana N Thompson

• Psychiatric/Mental Health Clinical Nurse Specialist in Durham, NC
• Providers in Durham, NC by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.