Individual provider Active NPI

Stephanie Farrior, AGNP

  • Adult Health Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1093358905
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
903446 Issued in MS
Practice address
1325 E Fortification St
Jackson, MS 39202-2442
Phone
(601) 354-4488
NPI assigned
Oct 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 903446 MS
Adult Health Nurse Practitioner 363LA2200X 903446 MS Primary

Addresses

Primary practice location

1325 E Fortification St
Jackson, MS 39202-2442

Mailing address

1325 E Fortification St
Jackson, MS 39202-2442
Phone (601) 354-4488

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
I20200130000500 MS Practitioner - Nurse Practitioner 8022444637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustcare Health, LLCGroup PAC ID 0547427858, 40 clinicians

Practice addresses (Care Compare)

1051 Highland Colony Pkwy
Suite E
Ridgeland, MS 39157-7701
Phone (601) 707-3737

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903446MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Nov 14, 2019 Accepting new patients
Mississippi Sports Medicine & Orthopaedic Center CurrentSince Oct 21, 2021 Accepting new patients
Trustcare Health, LLC CurrentSince Aug 7, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Nov 14, 2019 Accepting new patients
Trustcare Primary Care, LLC Past Accepting new patients

Locations

6176 U S Highway 98
Hattiesburg, MS 39402
Phone (601) 475-0444

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1325 E Fortification St
Jackson, MS 39202
Phone (601) 354-4488

1073 Highway 51
Ste 105
Madison, MS 39110
Phone (601) 203-1570

1073 Highway 51
Madison, MS 39110
Phone (601) 605-0402

1067 Highland Colony Pkwy
Ridgeland, MS 39157
Phone (601) 707-3490

1051 Highland Colony Pkwy
Ste E
Ridgeland, MS 39157
Phone (601) 707-3737

786 Lake Harbour Dr
Ridgeland, MS 39157
Phone (601) 499-0022

Interoperability endpoints

  • Direct secure messaging: stephanie.farrior.1@19538.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1093358905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIOR",
        "first_name": "STEPHANIE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "903446",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "903446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.