Jessie Watson, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

905835 Issued in MS

Practice address

1203 Avenue B Ste 200
Ellisville, MS 39437-2080

Phone

(601) 477-3550

Fax

(601) 477-2236

NPI assigned

Feb 22, 2023

Last updated

Oct 7, 2026By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

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.

• South Central Clinics, Inc.

  dba Ellisville Pediatric Clinic

  • Rural Health Clinic/Center
  • Ellisville, MS
  • NPI 1427098003
  NPD (past)

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1215635834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-399-6169",
            "fax_number": "601-399-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 AVENUE B STE 200",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394372080",
            "telephone_number": "601-477-3550",
            "fax_number": "601-477-2236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 B Ave",
            "address_purpose": "LOCATION",
            "city": "Ellisville",
            "state": "MS",
            "postal_code": "394372080",
            "country_code": "US",
            "telephone_number": "601-477-3550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JESSIE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "905835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mequandra Twillie, LMSW
• Sheila Vickers, IDD WAIVER SERVICES
• Walgreen Co (Ellisville Drug #15828, Powered by Walgreens)
• Nikki Red Walters
• Rebekah Walters
• Elizabeth Danielle Welch, NP
• Roxie West, IDD WAIVER SERVICES
• Ranesha Williams, IDD WAIVER SERVICES
• Augustus Joseph Woestman, PT, DPT
• Amy E Young, SLP

• Nurse Practitioner in Ellisville, MS
• Providers in Ellisville, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.