Willie Thompson Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

31482 Issued in MS

Practice address

514 E Woodrow Wilson Ave Ste a-B
Jackson, MS 39216-4538

Phone

(601) 321-2234

NPI assigned

Apr 29, 2014

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Central Mississippi Civic Improvement Association, Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1134151442
  Medicare reassignment NPD
• Central Mississippi Civic Improvement Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1215744396
  NPD
• Central Mississippi Civic Improvement Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1154424554
  NPD (past)
• Southeast Mississippi Rural Health Initiative, Inc.

  • Federally Qualified Health Center (FQHC)
  • Petal, MS
  • NPI 1225073968
  NPD (past)

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1760892830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 E WOODROW WILSON AVE STE A-B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164538",
            "telephone_number": "601-321-2234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-626-2445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "807 University Pky,",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37614",
            "country_code": "US",
            "telephone_number": "423-439-2225",
            "fax_number": "423-439-2250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "WILLIE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "31482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Thompson
• Regina Thompson
• Sarah Thompson
• Sarah Catherine Thompson, CFNP
• William O Thompson, M.D.
• Wyshieka Thompson, MA37676620140516
• Keith Derek Thorne, M.D.
• Mary Beth Thorne, M.D.
• Polly E Thornhill, LMSW
• Eric Thornton

• Psychiatry Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.