Individual provider Active NPI

Jennifer Johnson, FNP-C

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1134974686
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906620 Issued in MS
Practice address
1190 N State St Ste 502
Jackson, MS 39202-2414
Phone
(601) 944-1781
Fax
(601) 353-0439
NPI assigned
Apr 18, 2024
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 906620 MS Primary
Nurse Practitioner 363L00000X 906620 MS

Addresses

Primary practice location

1190 N State St Ste 502
Jackson, MS 39202-2414

Mailing address

591 Blue Ruin Rd
Louise, MS 39097-3100

Other practice location 1

230 Wyeth Ln
Yazoo City, MS 39194-4653
Phone (662) 746-8962

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
I20241008001444 MS Practitioner - Nurse Practitioner 0840721379 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Surgical Associates PLLCGroup PAC ID 1355359506, 27 clinicians
Curana Health of Mississippi LLCGroup PAC ID 3678887700, 18 clinicians
CH MSSP Services Ms LLCGroup PAC ID 7911441126, 16 clinicians

Practice addresses (Care Compare)

1190 N State St
Suite 502
Jackson, MS 39202-2414
Phone (601) 944-1781

232 Market St
Flowood, MS 39232-3339
Phone (337) 991-9276

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906620MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Mississippi LLC Family CurrentSince Aug 26, 2025 Accepting new patients
CH MSSP Services Ms LLC CurrentSince Aug 26, 2025 Accepting new patients
Central Surgical Associates PLLC CurrentSince Oct 1, 2024 Accepting new patients
Vibha Vig MD PA PastSince Apr 1, 2024 Accepting new patients
Vibha Vig MD PA PastSince Apr 1, 2024 Accepting new patients

Locations

1190 N State St
Ste 502
Jackson, MS 39202
Phone (601) 944-1781

1190 N State St
Ste L1
Jackson, MS 39202
Phone (601) 292-4292

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://rxedi.bmhcc.org/prd-fhir/CSA/api/FHIR/R4

Organizations & group practices 5

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 4

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": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1134974686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 BLUE RUIN RD",
            "city": "LOUISE",
            "state": "MS",
            "postal_code": "390973100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST STE 502",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022414",
            "telephone_number": "601-944-1781",
            "fax_number": "601-353-0439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Wyeth Ln",
            "address_purpose": "LOCATION",
            "city": "Yazoo City",
            "state": "MS",
            "postal_code": "391944653",
            "country_code": "US",
            "telephone_number": "662-746-8962",
            "fax_number": "662-746-8964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906620",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "906620",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.