Seren Emerson Ainsworth II, FNP-C
Individual provider Active NPI Family Medicine Physician · Biloxi, MS
NPI 1356900534 · NPPES record last updated Apr 8, 2020
Key facts
- NPI
- 1356900534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 903359 (MS)
- Practice address
- 15012 Lemoyne Blvd
Biloxi, MS 39532 - Phone
- (228) 392-5050
- Fax
- (228) 392-5318
- NPI assigned
- Jun 11, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Bay Family Medical Clinic, PA
Practice addresses (Care Compare)
15012 Lemoyne Blvd
Biloxi, MS 39532-5205
Phone (228) 392-5050
Hospital & facility affiliations
- Deaconess Homecare- Region I
- Singing River Gulfport
- Singing River Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210304001597 | MS | Practitioner - Nurse Practitioner | 9830505585 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 903359 | MS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Bay Family Medical Clinic, PA | Family Medicine | Current |
Accepting new patients |
Locations
15012 Lemoyne Blvd
Biloxi, MS 39532
Phone (228) 392-5050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 903359 | MS | Yes |
Addresses
Primary practice location
15012 Lemoyne Blvd
Biloxi, MS 39532
Mailing address
15012 Lemoyne Blvd
Biloxi, MS 39532-5205
Phone (228) 392-5050
Other practice location 1
15012 Lemoyne Blvd
Biloxi, MS 39532
Phone (228) 392-5050
Other practice location 2
15012 Lemoyne Blvd
Biloxi, MS 39532
Phone (228) 392-5050
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nbfmcpa@bellsouth.net | Direct |
Other providers in Biloxi, MS
- Dorothy Denise Adams
- Stephanie Lynn Addison
- Moses Oyegoke Adedeji
- Aesthetic Surgery Center LTD
- Ahmad Agha
- Adam Derrick Akers
- Kole Prasad Akula
- Belinda Alexander
- Brenda Lynn Alexander
- Kari Alexander
All providers in Biloxi, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.