SOUTHERN MENTALITY PLLC
NPI 1215617709
Nurse Practitioner - Psychiatric/Mental Health in Charlotte, NC
About Southern Mentality Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN MENTALITY PLLC (NPI 1215617709) is a healthcare organization registered as a psychiatric/mental health in Charlotte, North Carolina and active in the NPI registry since July 2023. The organization lists Nicole Jane Thompson, Ceo, Owner, Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Mentality Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Southern Mentality PLLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Corvallis, OR 97330
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southern Mentality PLLC's NPI number?
The NPI number for Southern Mentality PLLC is 1215617709. It was assigned to this organization in the NPPES registry on July 20, 2023.
Where is Southern Mentality PLLC located?
Southern Mentality PLLC is located at 1914 J N Pease Pl, Charlotte, NC 28262. The listed phone number is (704) 754-8718.
What is Southern Mentality PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Southern Mentality PLLC enrolled in Medicare?
Yes. Southern Mentality PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Mentality PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Southern Mentality PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (3) and Nurse Practitioner (3). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southern Mentality PLLC accept?
Health plans from Blue Cross and Blue Shield of NC list Southern Mentality PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southern Mentality PLLC was last updated on January 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southern Mentality Pllc · NPI 1215617709
Psychiatric/Mental Health organization in Charlotte, North Carolina. Organization record, active in the CMS NPPES registry since July 20, 2023.
## Identity
- **NPI:** 1215617709 (Entity type: Organization)
- **Enumerated:** July 20, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Nicole Thompson, CEO, OWNER, NURSE PRACTITIONER
## Practice location
- **Address:** 1914 J N PEASE PL, Charlotte, NC 28262-4504
- **Phone:** (704) 754-8718 · **Fax:** (704) 803-5923
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (3), Nurse Practitioner (3); 4 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 7, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1215617709) · Data from the CMS NPPES public registry.