Individual provider Active NPI

Megan Wallace Tyson, NP

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1346760220
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902116 Issued in MS
Practice address
1325 E Fortification St
Jackson, MS 39202-2442
Phone
(601) 354-4488
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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 902116 MS Primary

Addresses

Primary practice location

1325 E Fortification St
Jackson, MS 39202-2442

Mailing address

1325 E Fortification St
Jackson, MS 39202-2442

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
I20170821000246 MS Practitioner - Nurse Practitioner 7315219714 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
Mississippi Sports Medicine and Orthopaedic CenterGroup PAC ID 4981685310, 67 clinicians

Practice addresses (Care Compare)

1325 E Fortification St
Jackson, MS 39202-2442
Phone (601) 354-4488

4506 Lakeland Dr
Flowood, MS 39232-9583
Phone (601) 354-4488

501 Baptist Dr
Suite 120
Madison, MS 39110-2031
Phone (601) 354-4488

Hospital & facility affiliations

  • Merit Health River Oaks Hospital, Flowood, MS, CCN 250138
  • King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057
  • Winston Medical Center Hospital, Louisville, MS, CCN 250027
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902116MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Sports Medicine & Orthopaedic Center CurrentSince Jun 21, 2017 Accepting new patients
Sports Medicine Pharmacy LLC PastSince Oct 5, 2025 Accepting new patients

Locations

4506 Lakeland Dr
Flowood, MS 39232
Phone (601) 340-8861

1325 E Fortification St
Jackson, MS 39202
Phone (601) 354-4488

501 Baptist Dr
Madison, MS 39110
Phone (601) 856-7757

Organizations & group practices 2

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 5

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1346760220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "MEGAN",
        "middle_name": "WALLACE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.