Individual provider Active NPI

Susan Brinston

  • Medical-Surgical Registered Nurse
  • Jackson, MS
National Provider Identifier
1083203871
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
R862538 Issued in MS
Practice address
2832 Smith Robinson St
Jackson, MS 39213-6645
Phone
(601) 672-2947
NPI assigned
Jan 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X R862538 MS Primary

Addresses

Primary practice location

2832 Smith Robinson St
Jackson, MS 39213-6645

Mailing address

PO Box 3133
Jackson, MS 39207-3133

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Jackson Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R862538MSMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1083203871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3133",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392073133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2832 SMITH ROBINSON ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392136645",
            "telephone_number": "601-672-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINSTON",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MS",
            "license": "R862538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jackson",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2832 Smith Robinson St",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392136645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.