Jason Keith Ely

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9048725 Issued in MS

Practice address

15190 Community Rd Ste 260
Gulfport, MS 39503-3471

Phone

(228) 762-4483

Fax

(228) 762-3147

NPI assigned

Sep 10, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cooper Family Medical Center Inc.Group PAC ID 2860560125, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Singing River Health System Hospital, Pascagoula, MS, CCN 250040

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IBHCBA

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.

• Cooper Family Medical Center Inc.

  • Clinic/Center
  • Pascagoula, MS
  • NPI 1356478564
  Medicare reassignment Care Compare group NPD
• Community Medical Center

  • Rural Health Clinic/Center
  • Lucedale, MS
  • NPI 1194734913
  Medicare reassignment NPD
• George Regional ER Physicians

  • Emergency Medical Services (Emergency Medicine) Physician
  • Lucedale, MS
  • NPI 1043690936
  Medicare reassignment NPD
• Greene County Family Medical Clinic

  • Rural Health Clinic/Center
  • Leakesville, MS
  • NPI 1689821126
  Medicare reassignment NPD
• Hancock Emergency Group LLC

  • Emergency Medicine Physician
  • Bay St Louis, MS
  • NPI 1295142396
  Medicare reassignment NPD
• Orange Grove Urgent Care

  • Urgent Care Clinic/Center
  • Gulfport, MS
  • NPI 1831330661
  Medicare reassignment NPD
• Pascagoula Urgent Care

  • Urgent Care Clinic/Center
  • Pascagoula, MS
  • NPI 1235442872
  Medicare reassignment NPD
• Singing River Gulfport

  • Multi-Specialty Clinic/Center
  • Gulfport, MS
  • NPI 1861010159
  Medicare reassignment NPD
• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937
  Medicare reassignment NPD
• Wiggins Primary Care

  • Rural Health Clinic/Center
  • Wiggins, MS
  • NPI 1740293257
  Medicare reassignment NPD
• Inpatient Physician Services

  • Hospitalist Physician
  • Lucedale, MS
  • NPI 1427363928
  NPD
• Singing River Gulfport

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1487327193
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937

  Hospital

  Care Compare affiliation
• Singing River Health System

  • General Acute Care Hospital
  • Pascagoula, MS
  • NPI 1124136593
  Care Compare affiliation

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1104595396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340",
            "telephone_number": "228-497-7576",
            "fax_number": "228-497-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD STE 260",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033471",
            "telephone_number": "228-762-4483",
            "fax_number": "228-762-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "JASON",
        "middle_name": "KEITH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-10",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "9048725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jaely@direct.mysrhs.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "15190 Community Rd Ste 260",
            "city": "Gulfport",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395033471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Gilliand LPC LLC
• Lindsay Anne Elkins, LCSW
• Victoria Ellis
• Alicia Lee Ellsberry, FNP
• Linda W Elward, LMSW
• Sarah Emery, LCSW
• Encompass Health Rehabilitation Hospital of Gulfport, LLC
• Encore Rehabiliation Inc
• Encore Rehabilitation Inc
• Encore Rehabilitation Inc

• Family Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.