NPIMap

Individual provider Active NPI

Jessica Derrick, FNP-C

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1316779309
Registry record updated Aug 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906788 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-6200
NPI assigned
Aug 17, 2024
Last updated
Aug 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2024

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 906788 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022002153 MS Practitioner - Nurse Practitioner 2264964709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Mississippi School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laird Hospital, Inc.Group PAC ID 7214991769, 30 clinicians
Rush Medical FoundationGroup PAC ID 2567368541, shared by 7 NPIs, 31 clinicians

Practice addresses (Care Compare)

24489 Hwy 80
Lake, MS 39092-3511
Phone (601) 775-3264

252 Northside Dr
Newton, MS 39345-9756
Phone (601) 683-3117

317 Hwy 13 S
Morton, MS 39117-3353
Phone (601) 732-6301

321 Hwy 13 S
Morton, MS 39117-3353
Phone (601) 732-8612

603 S Archusa Ave
Ochsner Health Center Quitman
Quitman, MS 39355-2331
Phone (601) 776-2123

605 S Archusa Ave
Quitman, MS 39355-2331
Phone (601) 776-6925

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scott Regional Medical Center, Inc. Family CurrentSince Mar 1, 2025 Accepting new patients
Laird Hospital, Inc. Family CurrentSince Mar 1, 2025 Accepting new patients
Laird Hospital, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Scott Regional Medical Center, Inc Family Current Accepting new patients
Scott Regional Medical Center, Inc. Family CurrentSince Mar 1, 2025 Accepting new patients
Laird Hospital, Inc. Current Accepting new patients
Trustcare Primary Care, LLC Past Accepting new patients
Trustcare Health, LLC Past Accepting new patients

Locations

9097 Collinsville Rd
Collinsville, MS 39325
Phone (601) 626-8874

14884 Highway 15
Decatur, MS 39327
Phone (601) 635-2258

317 Highway 13 S
Morton, MS 39117
Phone (601) 732-6301

252 Northside Dr
Newton, MS 39345
Phone (601) 683-3117

Organizations & group practices 8

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.

Hospital & facility affiliations 7

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": "1723852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723852800000",
    "number": "1316779309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "JESSICA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-17",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.