Individual provider Active NPI

Jonathan Vinson, FNP-C

  • Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1164143087
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
905372 Issued in MS
Practice address
830 S Gloster St
Tupelo, MS 38801-4934
Phone
(662) 377-3000
NPI assigned
Sep 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 905372 MS Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801-4934

Mailing address

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-2774

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
I20221214001576 MS Practitioner - Nurse Practitioner 7315316312 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Express Care of Cleveland, LLCGroup PAC ID 0547502387, 14 clinicians

Practice addresses (Care Compare)

1515 University Ave
Oxford, MS 38655-4033
Phone (662) 238-0011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Inc. CurrentSince Jul 12, 2023 Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Sep 1, 2022 Accepting new patients
Express Care of Cleveland, LLC CurrentSince Dec 1, 2024 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Electrophysiology, LLC CurrentSince Apr 17, 2023 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jul 12, 2023 Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

609 N Davis Ave
Ste 105
Cleveland, MS 38732
Phone (662) 579-3958

1515 University Ave
Oxford, MS 38655
Phone (662) 238-0011

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

499 Gloster Creek Vlg
Ste A2
Tupelo, MS 38801
Phone (662) 620-6800

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

408 Council Cir
Ste A
Tupelo, MS 38801
Phone (662) 377-1130

4381 S Eason Blvd
Ste 101
Tupelo, MS 38801
Phone (662) 377-4054

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1164143087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "JONATHAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "905372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.