Individual provider Active NPI

Jana Louann Peterson, NP

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1023581857
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903085 Issued in MS
Practice address
499 Gloster Creek VLG
Ste A2
Tupelo, MS 38801-4749
Phone
(662) 620-6800
Fax
(662) 620-6950
NPI assigned
Jan 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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 903085 MS Primary

Addresses

Primary practice location

499 Gloster Creek VLG
Ste A2
Tupelo, MS 38801-4749

Mailing address

499 Gloster Creek VLG
Ste A2
Tupelo, MS 38801-4749
Phone (662) 620-6800

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
I20190408001020 MS Practitioner - Nurse Practitioner 8325389067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Clinics LLCGroup PAC ID 3870773914, 21 clinicians

Practice addresses (Care Compare)

499 Gloster Creek VLG
Suite A2
Tupelo, MS 38801-4749
Phone (662) 620-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903085MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Clinics LLC CurrentSince Mar 21, 2023 Accepting new patients
Cardiology Associates of North Ms PA CurrentSince Aug 2, 2021 Accepting new patients
North Mississippi Clinics LLC CurrentSince Mar 21, 2023 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Webster Health Services, Inc. Past Accepting new patients

Locations

2459 5th St N
Columbus, MS 39705
Phone (662) 327-3092

801 Stark Rd
Starkville, MS 39759
Phone (662) 324-1475

499 Gloster Creek Vlg
Ste A2
Tupelo, MS 38801
Phone (662) 620-6800

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: janapeterson@nmhs.medalliesdirect.net

Organizations & group practices 5

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 3

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": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1023581857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG",
            "address_2": "STE A2",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014749",
            "telephone_number": "662-620-6800",
            "fax_number": "662-620-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG",
            "address_2": "STE A2",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014749",
            "telephone_number": "662-620-6800",
            "fax_number": "662-620-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JANA",
        "middle_name": "LOUANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.