Priscilla Elizabeth Pulliam, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

865613 Issued in MS

Practice address

1030 River Oaks Dr
Jackson, MS 39232-9553

Phone

(601) 924-3719

NPI assigned

May 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grenada Emergency Group, LLCGroup PAC ID 2163854225, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holmes County Hospital and Clinics Hospital, Lexington, MS, CCN 251319
• Simpson General Hospital Cah Hospital, Mendenhall, MS, CCN 251317

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppulliam9964@ummc.direct-ci.com

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.

• Grenada Emergency Group, LLC

  • Emergency Medicine Physician
  • Grenada, MS
  • NPI 1194388082
  Medicare reassignment Care Compare group NPD
• App of Mississippi Ed, LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1730687740
  Medicare reassignment NPD
• Independent Healthcare Management, Inc.

  • Critical Access Hospital
  • Forest, MS
  • NPI 1306909734
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  Medicare reassignment NPD
• Independent Healthcare Management, Inc.

  • Rural Health Clinic/Center
  • Raleigh, MS
  • NPI 1871272724
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Family Medicine Physician
  • Lexington, MS
  • NPI 1013020395

  Emergency Medicine

  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• Sterling Emergency Services of Mississippi, Inc

  • Nurse Practitioner
  • Jackson, MS
  • NPI 1932167533

  Emergency Medicine

  NPD (past)

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

• Simpson Community Healthcare, Inc.

  • Critical Access Hospital
  • Mendenhall, MS
  • NPI 1144339839
  Care Compare affiliation
• State of Mississippi - University of Mississippi Medical Center

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705
  Care Compare affiliation

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1114975505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "JMM ROOM 2525",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6426",
            "fax_number": "601-984-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 RIVER OAKS DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329553",
            "telephone_number": "601-924-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "PRISCILLA",
        "middle_name": "ELIZABETH",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "865613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07338051",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Neal Puckett, CPNP-AC/PC
• Krista Puderbaugh, LPC
• Jenna Brooke Pugh, FNP
• D. Jeanette Pullen, M.D.
• Cindy Anne Pulliam, NP
• Louis V Puneky, MD
• Kevin Francis Purcell, MD
• Katherine Elise Purdom
• Pure Luxe Beauty and Bundles LLC
• Mable C Purnell, CCMA, MEDICAL DATA

• Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.