Individual provider Active NPI

Ashley Fitzhugh

  • Adult Health Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1356980817
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
903664 Issued in MS
Practice address
971 Lakeland Dr Ste 750
Jackson, MS 39216-4608
Phone
(601) 200-4970
Fax
(601) 200-4803
NPI assigned
Jan 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 903664 MS Primary

Addresses

Primary practice location

971 Lakeland Dr Ste 750
Jackson, MS 39216-4608

Mailing address

PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4970

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
I20200130001349 MS Practitioner - Nurse Practitioner 2668808205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Dominic Medical Associates LLCGroup PAC ID 0446303168, 130 clinicians

Practice addresses (Care Compare)

106 Highland Way
Madison, MS 39110-6933

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-3100

Hospital & facility affiliations

  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903664MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Dominic Medical Associates LLC Current Accepting new patients
St Dominic Medical Associates LLC CurrentSince Jan 6, 2020 Accepting new patients
St Dominic Medical Associates LLC CurrentSince Jan 6, 2020 Accepting new patients
St Dominic Medical Associates LLC Past Accepting new patients

Locations

971 Lakeland Dr
Ste 750
Jackson, MS 39216
Phone (601) 200-5955

106 Highland Way
Ste 202
Madison, MS 39110
Phone (601) 200-3376

Organizations & group practices 4

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 2

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": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1356980817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4970",
            "fax_number": "601-200-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR STE 750",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164608",
            "telephone_number": "601-200-4970",
            "fax_number": "601-200-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZHUGH",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "903664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.