Individual provider Active NPI

Monique McLaurin, FNP-BC

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1356805345
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903130 Issued in MS
Practice address
1190 N State St Ste 204
Jackson, MS 39202-2413
Phone
(601) 973-1624
NPI assigned
Jan 24, 2019
Last updated
Apr 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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 903130 MS Primary

Addresses

Primary practice location

1190 N State St Ste 204
Jackson, MS 39202-2413

Mailing address

1190 N State St Ste 204
Jackson, MS 39202-2413
Phone (601) 973-1624

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
I20190418000377 MS Practitioner - Nurse Practitioner 9537400684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1190 N State St
Jackson, MS 39202-2413
Phone (601) 944-1717

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903130MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation of Central Ms CurrentSince Apr 22, 2019 Accepting new patients
Baptist Nutrition Clinic CurrentSince Apr 22, 2019 Accepting new patients
Medical Foundation of Central Mississippi, Inc. Current Accepting new patients

Locations

1190 N State St
Ste 204
Jackson, MS 39202
Phone (601) 353-8066

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

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

Interoperability endpoints

  • Direct secure messaging: mmclaurin148635@direct.bmhcc.org

Organizations & group practices 3

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 1

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": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1356805345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST STE 204",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "601-973-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST STE 204",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "601-973-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAURIN",
        "first_name": "MONIQUE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.