Jessica Nicole McCain, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2021048428 Issued in MO

Practice address

2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396

Phone

(573) 776-2835

Fax

(573) 776-2763

NPI assigned

Dec 6, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: jessica.mccain.1@8825.direct.athenahealth.com

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1013675255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 KINZER ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014807",
            "telephone_number": "573-300-7944",
            "fax_number": "573-776-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013396",
            "telephone_number": "573-776-2835",
            "fax_number": "573-776-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAIN",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-06",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021048428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.mccain.1@8825.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "2620 N Westwood Blvd",
            "city": "Poplar Bluff",
            "state": "MO",
            "country_code": "US",
            "postal_code": "639013396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kaitlee Jade Mayabb
• Steven Kelly Mayse
• Starla Maze
• MB Moore MD
• Kaylea Rae McAlister, FSP
• Makala C McCauley, LCSW
• Candace McCollough
• Terrell McCollough, LPN
• Cross A McCollum
• Jason Lance McCollum

• Family Nurse Practitioner in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.