Julie A Ainsworth, NP
Individual provider Active NPI Nurse Practitioner · Gulfport, MS
NPI 1134717622 · NPPES record last updated May 2, 2023
Key facts
- NPI
- 1134717622
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 904352 (MS)
- Practice address
- 1340 Broad Ave Ste 410
Gulfport, MS 39501-2459 - Phone
- (228) 575-1775
- NPI assigned
- Jan 9, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Uppal Medical Center LLC
MDB Behavioral Health Services LLC
Practice addresses (Care Compare)
1727 E Union St
Greenville, MS 38703-3253
Phone (662) 537-4830
1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210127003617 | MS | Practitioner - Nurse Practitioner | 9931513231 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 904352 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uppal Medical Center LLC | Current |
Accepting new patients | |
| Memorial Hospital at Gulfport | Current |
Accepting new patients | |
| MDB Behavioral Health Services LLC | Current |
Accepting new patients | |
| Memorial Hospital at Gulfport | Current | Accepting new patients |
Locations
1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
1340 Broad Ave
Ste 410
Gulfport, MS 39501
Phone (228) 575-1775
215 Katherine Dr
#A
Jackson, MS 39232
Interoperability endpoints
- jbourgeois@direct.mhg.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 904352 | MS | Yes |
Addresses
Primary practice location
1340 Broad Ave Ste 410
Gulfport, MS 39501-2459
Mailing address
PO Box 1810
Gulfport, MS 39502-1810
Phone (228) 867-5326
Other names
- Julie A Bourgeois
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | jbourgeois@mhg.com |
Other providers in Gulfport, MS
- Charlotte Marie Aeger Ross
- Affinity Healthcare LLC
- Affordable Smiles of Gulfport, LLC
- John H Agnone
- Ali Ahmad
- Jared Akers
- Alabama Artificial Limb & Orthopedic Service, Inc.
- Adam Alamo
- Dana H Albrecht
- Mamie Albritton
All providers in Gulfport, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.