Anjanette Michelle Devine, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R874930 Issued in MS

Practice address

4541 N State St
Jackson, MS 39206-5308

Phone

(601) 533-7017

NPI assigned

Sep 2, 2011

Last updated

Mar 28, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Anjanette Michelle Jackson Former name

Medicare fee-for-service enrollment

Enrolled in MS, OR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Klamath Tribal Health and Family ServicesGroup PAC ID 9032027206, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anjanette.devinefnp.p1@direct.kthfs.nextgenshare.com

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.

• Klamath Tribal Health & Family Services

  • Federally Qualified Health Center (FQHC)
  • Chiloquin, OR
  • NPI 1629078274
  Medicare reassignment Care Compare group NPD
• Oak Street Health Physicians Group of Mississippi, LLC

  • Family Medicine Physician
  • Raymond, NH
  • NPI 1235754995

  MS

  Medicare reassignment NPD
• Klamath Tribal Health & Family Services

  dba Klamath Tribal Pharmacy - Klamath Falls

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Klamath Falls, OR
  • NPI 1730879446
  NPD
• Brenco

  • Podiatrist
  • Monticello, MS
  • NPI 1295818045
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1215218292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746085",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746085",
            "telephone_number": "469-727-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392065308",
            "telephone_number": "601-533-7017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 S Chiloquin Blvd",
            "address_purpose": "LOCATION",
            "city": "Chiloquin",
            "state": "OR",
            "postal_code": "976246747",
            "country_code": "US",
            "telephone_number": "541-882-1487 x380",
            "fax_number": "541-783-3273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "ANJANETTE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-02",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R874930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANJANETTE",
            "last_name": "JACKSON",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Marie Desselles, LCSW
• Destin Healthcare Inc
• Destin Healthcare Inc
• Courtney Paige Detwiler
• Heather Dawn Deville, DO
• Gwen Dew, PMHNP-BC
• James M Dew, MD
• Charles Curtis Deware
• Mary Rolfe Deweese, PA
• Maya D Dezell

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.