Individual provider Active NPI

Panchanok Chumpumud Thompson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Plano, TX
National Provider Identifier
1609384197
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP135936 Issued in TX
Practice address
6404 International Pkwy Ste 1010
Plano, TX 75093-8346
Phone
(972) 267-1988
NPI assigned
Jan 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X AP135936 TX Primary

Addresses

Primary practice location

6404 International Pkwy Ste 1010
Plano, TX 75093-8346

Mailing address

6404 International Pkwy Ste 1010
Plano, TX 75093-8346
Phone (972) 267-1988

Other practice location 1

8111 Lbj Fwy Ste 900
Dallas, TX 75251-1322
Phone (214) 366-9407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180605002093 TX Practitioner - Nurse Practitioner 1759646177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Behavioral Health AuthorityGroup PAC ID 2769804350, 9 clinicians

Practice addresses (Care Compare)

6404 International Pkwy
Suite 1010
Plano, TX 75093-8346
Phone (972) 267-1988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Medical Associates, PA Single Specialty CurrentSince Apr 26, 2025 Accepting new patients
North Texas Behavioral Health Authority Single Specialty CurrentSince Oct 5, 2025 Accepting new patients
North Texas Behavioral Health Authority PastSince Apr 24, 2022 Accepting new patients

Locations

8111 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75251
Phone (214) 366-9407

3001 Al Lipscomb Way
Dallas, TX 75215
Phone (214) 366-9407

108 W Grove St
Kaufman, TX 75142
Phone (214) 366-9407

6404 International Pkwy
Ste 1010
Plano, TX 75093
Phone (972) 267-1988

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.

NPI Registry JSON

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1609384197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 INTERNATIONAL PKWY STE 1010",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938346",
            "telephone_number": "972-267-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 INTERNATIONAL PKWY STE 1010",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938346",
            "telephone_number": "972-267-1988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8111 Lbj Fwy Ste 900",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752511322",
            "country_code": "US",
            "telephone_number": "214-366-9407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "PANCHANOK",
        "middle_name": "CHUMPUMUD",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP135936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.