MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C) – Adult Health Nurse Practitioner, NPI 1174122121

MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C) is a healthcare provider. based in Magnolia, Arkansas. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN, APRN, AGNP-C. They hold a License No. 212494 (AR). The NPI Number for MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C) is 1174122121

Main info

Male
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C)
NPI
1174122121
Phone
Not provided
Address
PO BOX 25
Enumeration Date
21 October 2020
Last Update Date
23 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8708952015
Graduation Year
2020 (6 years ago)
PAC ID
0143610832
Group Practice PAC ID
5890077093
Professional Enrollment ID
I20211213001403
Address ID
AR717306526EL2280XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,410 NURSE PRACTITIONER in AR

Provider Addresses for MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C)

  • PO BOX 25

    MAGNOLIA, AR 717540025

    Phone:

    Type: Mailing

  • 1411 TERRACE

    MAGNOLIA, AR 717532040

    Phone: (870) 562-2383

    Type: Location

  • 3002 MOORES LN

    TEXARKANA, TX 755032204

    Phone: (430) 200-4350

    Fax: (833) 491-2722

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $194.

Total Amount is formed as General ($194) + Research ($0) + Ownership ($0) = $194.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: ABBVIE INC. ($92).

Total Amount

$194

General + Research + Ownership

Payments

3

Total payment records

General Amount

$194

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-12-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20211213001403INurse PractitionerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 71754)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5890077093View full group profile
NameSpecialtyState
Nurse PractitionerAR
Nurse PractitionerAR
Nurse PractitionerAR
Nurse PractitionerOK
Family Practice, Geriatric MedicineAR
-AR
Nurse PractitionerAR
Nurse PractitionerAR
Nurse PractitionerAR
-AR

Reviews

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Frequently asked questions

What number should I use to identify MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C) for billing?
Administrative and clinical systems typically use NPI 1174122121 for MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C).
Does the public listing show MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C) as active?
MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C)'s NPI record reflects an active status in NPPES.
What does the directory say MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C) does?
Insurance directories may phrase it differently, but here MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C) maps to Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C) tied to Magnolia, Arkansas?
If you are local to Magnolia, Arkansas, MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C) may be relevant to your search.
Why is information missing for MR. JOHN MYCHAL THOMPSON (MSN, APRN, AGNP-C)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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