Individual provider Active NPI

Jerad Robinson

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1144687583
Registry record updated Sep 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
882802 Issued in MS
Practice address
971 Lakeland Dr
Jackson, MS 39216-4643
Phone
(601) 939-4230
Fax
(601) 664-6694
NPI assigned
Jan 15, 2016
Last updated
Sep 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2026

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 882802 MS Primary

Addresses

Primary practice location

971 Lakeland Dr
Jackson, MS 39216-4643

Mailing address

971 Lakeland Dr
Jackson, MS 39216-4643
Phone (601) 939-4230

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
I20160328000050 MS Practitioner - Nurse Practitioner 7214234822 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Pain Center of MississippiGroup PAC ID 5193893014, 5 clinicians
Seshadri Raju, M.D., PA.Group PAC ID 3971674896, 8 clinicians

Practice addresses (Care Compare)

129 Fountains Blvd
Suite 201
Madison, MS 39110-6361
Phone (769) 300-0730

971 Lakeland Dr
Suite 401
Jackson, MS 39216-4607
Phone (601) 939-4230

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
882802MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pain Center of Mississippi CurrentSince Nov 1, 2023 Accepting new patients

Locations

129 Fountains Blvd
Madison, MS 39110
Phone (769) 300-0720

129 Fountains Blvd
Ste 201
Madison, MS 39110
Phone (769) 300-0730

Interoperability endpoints

  • Direct secure messaging: jerad.robinson.1@33737.direct.athenahealth.com

Organizations & group practices 2

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": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790467200000",
    "number": "1144687583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-939-4230",
            "fax_number": "601-664-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-939-4230",
            "fax_number": "601-664-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JERAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-15",
        "last_updated": "2026-09-27",
        "certification_date": "2026-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "882802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.