Individual provider Active NPI

Genessa Nicole Egerson, FNP-C

  • Family Nurse Practitioner
  • Batesville, MS
National Provider Identifier
1104496421
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904660 Issued in MS
Practice address
303 Medical Center Dr
Batesville, MS 38606-8608
Phone
(662) 563-5611
NPI assigned
Jun 29, 2021
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 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 904660 MS Primary

Addresses

Primary practice location

303 Medical Center Dr
Batesville, MS 38606-8608

Mailing address

123 Yocona Ridge Rd
Oxford, MS 38655-6905
Phone (662) 701-7203

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
I20210913000789 MS Practitioner - Nurse Practitioner 6204232580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1705 Crescent Meadow Dr
Holly Springs, MS 38635
Phone (662) 502-3149

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Primary Health Care, Inc. CurrentSince Sep 23, 2024 Accepting new patients
North Mississippi Primary Health Care, Inc. CurrentSince Sep 23, 2024 Accepting new patients
North Mississippi Primary Health Care, Inc. Past Accepting new patients

Locations

1705 Crescent Meadows Dr
Holly Springs, MS 38635
Phone (662) 502-3149

Organizations & group practices 3

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 7

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1104496421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 YOCONA RIDGE RD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386556905",
            "telephone_number": "662-701-7203",
            "fax_number": "662-712-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MEDICAL CENTER DR",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386068608",
            "telephone_number": "662-563-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGERSON",
        "first_name": "GENESSA",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, MS

Sources for this page

Verify at the official NPI Registry.