Individual provider Active NPI

Jennifer Lynn Chatman Malley, NP

  • Family Nurse Practitioner
  • Biloxi, MS
National Provider Identifier
1023314416
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R862452 Issued in MS
Practice address
250 Beauvoir Rd
Biloxi, MS 39531-4026
Phone
(228) 388-2994
NPI assigned
Feb 1, 2011
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 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 R862452 MS Primary

Addresses

Primary practice location

250 Beauvoir Rd
Biloxi, MS 39531-4026

Mailing address

250 Beauvoir Rd
Biloxi, MS 39531-4026
Phone (228) 388-2994

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
I20120709000699 MS Practitioner - Nurse Practitioner 5193999399 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

3265 Hwy 90
Gautier, MS 39553-5121
Phone (931) 253-1110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R862452MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 15, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Jan 1, 2024 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 15, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Jan 1, 2024 Accepting new patients
Clinical Consultants of Louisiana LLC PastSince Oct 25, 2011 Accepting new patients
Mid-Florida Dermatology Associates P.a. Past Accepting new patients

Locations

3265 Highway 90
Gautier, MS 39553
Phone (228) 366-9136

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

Organizations & group practices 7

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.

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": "1296518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1023314416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BEAUVOIR RD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395314026",
            "telephone_number": "228-388-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BEAUVOIR RD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395314026",
            "telephone_number": "228-388-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATMAN MALLEY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-01",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R862452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.