Individual provider Active NPI

Jennifer Lynette South, FNP-C

  • Family Nurse Practitioner
  • Corinth, MS
National Provider Identifier
1013492248
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902957 Issued in MS
Practice address
703 Alcorn Dr Ste 109
Corinth, MS 38834-9302
Phone
(662) 660-9300
NPI assigned
Oct 3, 2018
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 902957 MS Primary

Addresses

Primary practice location

703 Alcorn Dr Ste 109
Corinth, MS 38834-9302

Mailing address

401 Alcorn Dr Ste 2C
Corinth, MS 38834-9073
Phone (662) 293-7266

Other practice location 1

611 Alcorn Dr
Corinth, MS 38834-9388
Phone (662) 293-7666

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
I20190116001210 MS Practitioner - Nurse Practitioner 5890031694 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center CurrentSince Oct 5, 2018 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center CurrentSince Oct 5, 2018 Accepting new patients
Magnolia Regional Health Center CurrentSince Oct 5, 2018 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Current Accepting new patients

Locations

3704 Highway 72 W
Corinth, MS 38834
Phone (662) 286-1499

401 Alcorn Dr
Ste 2C
Corinth, MS 38834
Phone (662) 286-9255

401 Alcorn Dr
Ste 2D
Corinth, MS 38834
Phone (662) 293-1565

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

703 Alcorn Dr
Ste 109
Corinth, MS 38834
Phone (662) 286-1499

Interoperability endpoints

  • Direct secure messaging: jennifersartin@magnolia.medalliesdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1013492248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ALCORN DR STE 2C",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349073",
            "telephone_number": "662-293-7266",
            "fax_number": "662-293-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 ALCORN DR STE 109",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349302",
            "telephone_number": "662-660-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Alcorn Dr",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "MS",
            "postal_code": "388349388",
            "country_code": "US",
            "telephone_number": "662-293-7666",
            "fax_number": "662-293-6230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "JENNIFER",
        "middle_name": "LYNETTE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.