Tiffany Jackson, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F0115051 Issued in MS

Practice address

404 Riverwind Dr Ste B-1
Pearl, MS 39208-5900

Phone

(601) 623-9245

Fax

(601) 623-9246

NPI assigned

Mar 2, 2015

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjackson@kfpcl-ms.direct.office.nextgen.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.

• Kids First Pediatric & Adult Medicine, LLC

  • Family Health Clinical Nurse Specialist
  • Hazlehurst, MS
  • NPI 1356701783
  Medicare reassignment NPD Authorized official
• Kids First Pediatric & Adult Medicine, LLC

  • Family Health Clinical Nurse Specialist
  • Pearl, MS
  • NPI 1285305060
  NPD Authorized official

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1124410022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 495",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392050495",
            "telephone_number": "601-623-9245",
            "fax_number": "601-623-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 RIVERWIND DR STE B-1",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392085900",
            "telephone_number": "601-623-9245",
            "fax_number": "601-623-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TIFFANY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "F0115051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07833786",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Infusion Partners LLC
• Infusion Partners, LLC
• Robert W Inzer, M.D.
• Nashamba Jackson-Bracey, FNP-C
• Candace Jackson
• Jacksonbracey Health Care
• Jessica Johnson, CPHT
• Joyce M Johnson, MN, RN, CFNP
• Kurt Darwin Johnson, MD
• Teleshia Danielle Johnson, DMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.