Individual provider Active NPI

Cameron Nicole Howard, NP-C

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1265080584
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903120 Issued in MS
Practice address
501 Marshall St Ste 104
Jackson, MS 39202-1663
Phone
(601) 969-6404
Fax
(601) 973-4569
NPI assigned
Aug 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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 903120 MS Primary

Addresses

Primary practice location

501 Marshall St Ste 104
Jackson, MS 39202-1663

Mailing address

PO Box 321359
Flowood, MS 39232-1359
Phone (601) 936-1395

Other practice location 1

1860 Chadwick Dr Ste 256
Jackson, MS 39204-3486
Phone (601) 376-1394

Other practice location 2

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (601) 376-1000

Other identifiers 1

IdentifierTypeStateIssuer
03770032MedicaidMS

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
I20200402001743 MS Practitioner - Nurse Practitioner 5890124499 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Baptist Medical Center, Inc. Current Accepting new patients
Medical Foundation of Central Ms CurrentSince Nov 7, 2022 Accepting new patients
Mississippi Baptist Medical Center, Inc CurrentSince Nov 7, 2022 Accepting new patients
Medical Foundation of Central Mississippi, Inc. CurrentSince Nov 7, 2022 Accepting new patients
Mississippi Baptist Medical Center, Inc. CurrentSince Nov 7, 2022 Accepting new patients
River Oaks Management Company LLC Past Accepting new patients

Locations

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

501 Marshall St
Ste 104
Jackson, MS 39202
Phone (601) 973-4541

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

Organizations & group practices 6

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": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1265080584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321359",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392321359",
            "telephone_number": "601-936-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 104",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021663",
            "telephone_number": "601-969-6404",
            "fax_number": "601-973-4569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1860 Chadwick Dr Ste 256",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392043486",
            "country_code": "US",
            "telephone_number": "601-376-1394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 Chadwick Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392043404",
            "country_code": "US",
            "telephone_number": "601-376-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "CAMERON",
        "middle_name": "NICOLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03770032",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.