Individual provider Active NPI

Jennifer Nichols Foreman, A-GNP-C

  • Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1003281916
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
901418 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5657
NPI assigned
Dec 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 901418 MS Primary
Registered Nurse 163W00000X 882741 MS

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 North State Street
JMM Room 2525
Jackson, MS 39216-4500
Phone (601) 984-6426

Other identifiers 1

IdentifierTypeStateIssuer
01604356MedicaidMS

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160411000818 MS Practitioner - Nurse Practitioner 5193023034 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 898-4404

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
882741MSMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Traditions Hospice of Ridgeland, LLC CurrentSince Sep 16, 2020 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Mar 14, 2016 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Mar 14, 2016 Accepting new patients

Locations

2500 N State St
Rm 2525
Jackson, MS 39216
Phone (601) 984-1530

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

680 Highway 51
Ste L
Ridgeland, MS 39157
Phone (601) 317-4947

8150 N Central Expy
Ste 1800
Dallas, TX 75206
Phone (469) 501-1602

Interoperability endpoints

  • Direct secure messaging: jforeman6442@ummc.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1003281916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "JMM ROOM 2525",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6426",
            "fax_number": "601-984-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "JENNIFER",
        "middle_name": "NICHOLS",
        "credential": "A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "901418",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "882741",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01604356",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.