Individual provider Active NPI

Kristin Lee Scoggins, FNP-BC

  • Pulmonary Disease Physician
  • Jackson, MS
National Provider Identifier
1114789781
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
906470 Issued in MS
Practice address
501 Marshall St Ste 200
Jackson, MS 39202-1687
Phone
(601) 914-9503
Fax
(601) 371-3775
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 906470 MS Primary

Addresses

Primary practice location

501 Marshall St Ste 200
Jackson, MS 39202-1687

Mailing address

501 Marshall St Ste 200
Jackson, MS 39202-1687
Phone (601) 914-9503

Other identifiers 1

IdentifierTypeStateIssuer
003081551MedicaidMS

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
I20240319001551 MS Practitioner - Nurse Practitioner 9830536465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Pulmonary Associates, PAGroup PAC ID 7517934292, 33 clinicians

Practice addresses (Care Compare)

971 Lakeland Dr
Suite 1052
Jackson, MS 39216-4609
Phone (601) 981-9503

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Pulmonary Associates, PA Pulmonary Disease CurrentSince Mar 1, 2024 Accepting new patients

Locations

971 Lakeland Dr
Ste 1052
Jackson, MS 39216
Phone (601) 981-9503

501 Marshall St
Ste 200
Jackson, MS 39202
Phone (601) 354-8895

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.323

Organizations & group practices 1

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 2

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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1114789781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 200",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021687",
            "telephone_number": "601-914-9503",
            "fax_number": "601-371-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 200",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021687",
            "telephone_number": "601-914-9503",
            "fax_number": "601-371-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOGGINS",
        "first_name": "KRISTIN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MS",
            "license": "906470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003081551",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.