Individual provider Active NPI

Lynn Ann Vincent, ACNP

  • Acute Care Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1023249497
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R724394 Issued in MS
Practice address
970 Lakeland Dr
Suite 61
Jackson, MS 39216-4635
Phone
(601) 982-7850
Fax
(601) 366-8507
NPI assigned
Aug 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R724394 MS Primary

Addresses

Primary practice location

970 Lakeland Dr
Suite 61
Jackson, MS 39216-4635

Mailing address

970 Lakeland Dr
Suite 61
Jackson, MS 39216-4635
Phone (601) 982-7850

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
I20091228000441 MS Practitioner - Nurse Practitioner 1759421621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Heart Clinic. P.a.Group PAC ID 0547204091, 40 clinicians

Practice addresses (Care Compare)

970 Lakeland Dr
Suite 61
Jackson, MS 39216-4634
Phone (601) 982-7850

Hospital & facility affiliations

  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Merit-based Incentive Payment System (MIPS)

Final score
86.07 of 100Reported as group
Quality
74.67
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R724394MSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients

Organizations & group practices 2

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": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1023249497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR",
            "address_2": "SUITE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164635",
            "telephone_number": "601-982-7850",
            "fax_number": "601-366-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR",
            "address_2": "SUITE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164635",
            "telephone_number": "601-982-7850",
            "fax_number": "601-366-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "LYNN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-04",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R724394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.