Individual provider Active NPI

Jesse James Parker, FNP-C

  • Family Nurse Practitioner
  • Columbus, MS
National Provider Identifier
1124695739
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
879392 Issued in MS
Practice address
2520 5TH St N
Columbus, MS 39705-2008
Phone
(662) 244-1000
NPI assigned
Jun 10, 2021
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 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 879392 MS Primary

Addresses

Primary practice location

2520 5TH St N
Columbus, MS 39705-2008

Mailing address

20010 US Highway 82
Maben, MS 39750-9202
Phone (662) 414-6842

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
I20210723002599 MS Practitioner - Nurse Practitioner 8527461821 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

78 Hospital Rd
Macon, MS 39341-2490
Phone (662) 726-4231

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
879392MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Noxubee General Critical Access Hospital CurrentSince Nov 3, 2023 Accepting new patients
Tallahatchie General Hospital CurrentSince Jul 1, 2025 Accepting new patients
Noxubee General Critical Access Hospital CurrentSince Nov 3, 2023 Accepting new patients
Choctaw Regional Medical Center CurrentSince Jan 2, 2023 Accepting new patients
Tallahatchie General Hospital CurrentSince Jul 1, 2025 Accepting new patients
United Emergency Services of Mississippi CurrentSince Jun 20, 2021 Accepting new patients

Locations

8613 MS Highway 12
Ackerman, MS 39735
Phone (662) 285-4400

2520 5th St N
Columbus, MS 39705
Phone (662) 224-1000

1301 Sunset Dr
Ste E
Grenada, MS 38901
Phone (662) 229-0069

78 Hospital Rd
Macon, MS 39341
Phone (662) 726-4231

Organizations & group practices 7

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 1

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": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1124695739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20010 US HIGHWAY 82",
            "city": "MABEN",
            "state": "MS",
            "postal_code": "397509202",
            "telephone_number": "662-414-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052008",
            "telephone_number": "662-244-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JESSE",
        "middle_name": "JAMES",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "879392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

Verify at the official NPI Registry.