Individual provider Active NPI

Jennifer Elaine Lacroix, FNP, RNFA

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1255869665
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902195 Issued in MS
Practice address
7148 Hwy 98 West
Suite 203
Hattiesburg, MS 39402
Phone
(601) 268-5630
NPI assigned
May 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 902195 MS
Nurse Practitioner 363L00000X 902195 MS
Family Nurse Practitioner 363LF0000X 902195 MS Primary

Addresses

Primary practice location

7148 Hwy 98 West
Suite 203
Hattiesburg, MS 39402

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 268-5630

Other identifiers 1

IdentifierTypeStateIssuer
08339702MedicaidMS

Other names 1

  • Jennifer Lacroix Gunther Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgunther63629@directpatientrecord.com Health Information Exchange (HIE)

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
I20170922000933 MS Practitioner - Nurse Practitioner 6406120930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic, PA CurrentSince Aug 28, 2017 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Nov 5, 2023 Accepting new patients
Hattiesburg Clinic PA CurrentSince Aug 28, 2017 Accepting new patients
State of Mississippi - University of Mississippi Medical Center PastSince Aug 1, 2022 Accepting new patients

Locations

104 Millsaps Dr
Hattiesburg, MS 39402
Phone (601) 268-5170

103 Medical Park
Fl 2
Hattiesburg, MS 39401
Phone (601) 268-5630

103 Medical Park
Hattiesburg, MS 39401
Phone (601) 268-5630

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

Interoperability endpoints

  • Direct secure messaging: jgunther63629@directpatientrecord.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1255869665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5630",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7148 HWY 98 WEST",
            "address_2": "SUITE 203",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-268-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACROIX",
        "first_name": "JENNIFER",
        "middle_name": "ELAINE",
        "credential": "FNP, RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2023-11-01",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MS",
            "license": "902195",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "902195",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08339702",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgunther63629@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "7148 Hwy 98 West",
            "address_2": "Suite 203",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GUNTHER",
            "middle_name": "LACROIX",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.